Table 1 Description of all studies included
From: Cardiac biomarkers in acute respiratory distress syndrome: a systematic review and meta-analysis
Study | Cardiac biomarker | Type of study | No patients | Mean age | Baseline illness severity score | Mortality outcome | Overall mortality rate (%) | Biomarker cut-point (method determined) | Unadjusted results | Adjusted results | Adjusted variables |
|---|---|---|---|---|---|---|---|---|---|---|---|
Bajwa 2008 [14] | NT-proBNP | Prospective cohort | 177 | 60.1 | APACHE III: 79.6 | 60 day | 40 | 6813 pg/ml (ROC) | OR: 4.24 (CI 2.17-8.27) | OR: 2.36 (CI 1.11-4.99) | Age, APACHE III |
Park 2011 [15] | NT-proBNP | Prospective cohort | 49 | 64 | APACHE II: 22 SOFA: 8 | 28 day | 63.26 | NA | Median value in survivors vs non-survivors (3999 vs 2819, p=0.719) | NA | NA |
Lai 2017 [16] | NT-proBNP | Prospective cohort | 61 | 65 | APACHE II: 23 SOFA: 11 | 28 day | 55.7 | NA | HR: 1.006 (1.002–1.010) p=0.002 | HR: 1.009 (CI 1.004–1.013) | Age, APACHE II |
Lin 2012 [17] | NT-proBNP | Prospective cohort | 87 | 61 | APACHE II: 20 | 30 day | 31 | 2417 pg/ml (ROC) | HR: 2.52 (1.58-3.67) p=0.021 | 2.18 (1.54-4.46) p=0.026 | APACHE II, LIS Cr, copeptin, increase in copeptin, increase in BNP |
Zhou 2015 [18] | NT-proBNP | Prospective cohort | 87 | 47.1 | APACHE II: 22.78 | 28 day | 32.2 | 333.92 pg/ml (ROC) | Median value in survivors vs non-survivors (231.59 vs299.98, p<0.05) | HR: 1.925 (CI 1.512-3.026) p<0.05 | APACHE II, Murray score, extrapulmonary organ failures, oxygenation index |
Ji 2016 [19] | NT-proBNP | Prospective cohort | 80 | NR | NR | 28 day | 37.5 | NA | Median value in survivors vs non-survivors (3414 vs 5212, p<0.01) | NA | NA |
Xu 2013 [20] | NT-proBNP | Prospective cohort | 50 | 49.0 | NR | 28 day | 20 | 335 pg/ml (ROC) | ROC AUC 0.96 Sn 80%, Sp 92.5% Median value in survivors vs non-survivors (237.64 vs 287.86, p<0.01) | NA | NA |
Su 2018 [21] | NT-proBNP | Prospective cohort | 51 | 49.3 | APACHE II: 22.86 | 28 day | 47.6 | NR | ROC AUC 0.832 Sn 79.2%, Sp 74.1% Median value in survivors vs non-survivors (2868 vs 3881, p<0.05) | NA | NA |
Ferris 2019 [22] | NT-proBNP | Retrospective analysis of RCT | 262 | 55.7 | SOFA: 8.54 | 28 day | 27 | 751.553 pg/ml (median) | OR: 1.93 (CI 1.27-2.92), patients randomised to simvastatin with high BNP had lower mortality than placebo. | NA | NA |
Bonizzoli 2018 [23] | NT-proBNP Trop-I | Prospective cohort | 30 | 58 | SAPS II: 43.2 | ICU | 33.3 | NA | Median value in survivors vs non-survivors (NT-proBNP 1250 vs 3091 p= 0.009, Trop-I 0.12 vs 0.32 p= 0.04) | NA | NA |
Nassar 2010 [24] | NT-proBNP Trop-I TropT | Prospective cohort | 20 | 58.9 | NR | 30 day | 65 | NT-proBNP: 1200 pg/mL, Tn-I 1.5 ng/mL, Tn-T 0.5 ng/mL. | Median value in survivors vs non-survivors (NT-proBNP 712.0 vs 8975.9, Trop-I 0.2 vs 4.75, Trop-T 0 vs 0.51 p<0.001 for all three biomarkers), NT-proBNP sn 92%, sp 100%, Trop-I sn 100%, sp 57%, Trop-T sn 100%, sp 43% | NA | NA |
Sun 2015 [25] | BNP | Prospective cohort | 59 | 58.4 | NR | 28 day | 30.5 | NA | Mean value in survivors vs non-survivors (128.99 SD45.2 vs 267.07 SD 45.06, p <0.01) | NA | NA |
Semler 2016 [26] | BNP | Retrospective analysis of RCT | 625 | 49.4 | APACHE III: 93.25 | 60 day | 21.76 | 825 pg/ml (median) | OR: 0.927 (CI 0.811-1.062) | NA | NA |
Cepkova 2011 [27] | BNP | Prospective cohort | 42 | 62 | SAPS II: 45 APACHE II: 21 | 30 day | 36 | NA | Median value in survivors vs non-survivors (385 vs 420 pg/ml, p=0.71) | NA | NA |
Karmpaliotis 2007 [28] | BNP | Prospective cohort | 51 | 62 | APACHE II: 20 | In-hospital mortality | 42.4 | NA | Mortality in lowest tertile vs highest tertile BNP (26.1% vs 60.9% p=0.07) | NA | NA |
Rhee 2007 [29] | BNP | Prospective cohort | 47 | 65.7 | APACHE II: 21 | 30 day | 63.8 | 585 pg/ml | Median value in survivors vs non-survivors (219.5 vs 492.3 pg/ml p=0.013) Sn 43% Sp 94% | NA | NA |
Lin 2010 [30] | BNP | Prospective cohort | 86 | NR | NR | 14 day | 63.9 | 329.5 pg/ml (ROC) | Median value in survivors vs non-survivors (179.5 vs 550.8 pg/ml p<0.01) ROC AUC 0.96 Sn 80%, Sp 92.5% at cut-off 335 pg/ml | NA | NA |
Rivara 2012 [31] | Trop-T | Prospective cohort | 177 | 62.1 | APACHE III: 79.72 | 60 day | 39.5 | 0.036 ng/mL (ROC) | HR 1.33 (CI 1.10–1.62) [p=0.003] Median in survivors vs non-survivors (0.022 vs 0.042 p=0.008) | HR: 1.44 (CI 1.14-1.81) [p=0.002] | Daily MODS, VFDs |
Bajwa 2007 [32] | Trop-T | Prospective cohort | 248 | 61.5 | APACHE III: 82.4 | 60 day | 47 | 0.09 ng/mL (PD) | OR: 4 1.72 (CI 1.02-2.90) [p=0.04] ROC AUC Trop-T 0.63 | OR: 1.48 (CI 0.82-2.69) [p=0.19] | APACHE III, presence of septic shock, Cr, diabetes |
Lazzeri 2016 [33] | Trop-I | Prospective cohort | 42 | 55.5 | SAPS II: 39.7 | ICU | 47.6 | <0.1 ng/ml (PD) | Mortality in high vs low Trop-I (56.25% vs 42.3% p= NS) | NA | NA |
Austin 2009 [34] | Trop-I CKMBI | Retrospective cohort | 51 | 62.3 | NR | ICU | 43 | Tn-I: 0.59ng/mL CKMBI: 5 (PD) | Mortality in high vs low Trop-I (42.8% vs 43.3% p=0.973) | NA | NA |
Metkus 2017 [35] | HS-Trop-I | Retrospective analysis of RCT | 1057 | 50.4 | SOFA: 7.7 | 60 day | 28 | NA | HR: 1.57 (1.17-2.11) [0.003] comparing 1st with 5th quintile | HR: 1.01 (CI 0.73-1.39) [p=0.94] | Age, sex, randomised trial assignment (for unadjusted), further adjusted for SOFA, vasopressors, heart rate |