Circulating MicroRNA-499 as a Diagnostic Biomarker for Acute Myocardial Infarction: A Meta-analysis

Background. Recent studies have shown that circulating microRNA-499 could be a powerful biomarker of acute myocardial infarction (AMI). Interest in circulating microRNA-499 for detecting AMI is increasing rapidly. To evaluate the diagnosis of circulating microRNA-499 for AMI, this study was performed. Methods. We searched PubMed, Embase, and the Cochrane Library for studies published up to December 31, 2018, as well as the reference lists of relevant studies. Studies were included if they assessed the accuracy of blood circulating microRNA-499 or cardiac troponin T (cTnT) for AMI and provided sufficient data to construct a 2×2 contingency table. Extracted data were analysed for sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operator curve (SROC) analyses. Prespecified subgroup analysis and metaregression were also performed. Results. Fourteen studies including 3816 participants were included in this meta-analysis. The overall pooled sensitivity and specificity were 0.84 (95% CI: 0.64-0.94) and 0.97 (95% CI: 0.90-0.99), respectively. The area under the SROC curve (AUC) was 0.98 (95% CI: 0.96-0.99). The studies had substantial heterogeneity (I2=98.74%). Seven studies also used cTnT as a marker for the diagnosis of AMI. The overall pooled sensitivity and specificity of cTnT were 0.95 (95% CI: 0.87-0.98) and 0.96 (95% CI: 0.85-0.99), respectively. The area under the SROC curve (AUC) was 0.99 (95% CI: 0.97-0.99). The DOR of circulating miR-499 and cTnT were 188 (95% CI: 19-1815) and 420 (95% CI: 86-2038), respectively. Metaregression analysis suggested that specimen and healthy controls were the main sources of heterogeneity. No publication bias was suggested by Deeks’ regression test of asymmetrical funnel plot (t=0.85; p value = 0.41). Conclusion. The results showed that circulating microRNA-499 is a reliable biomarker for diagnosing AMI patients.

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The Prognostic Value of Early Repolarization Pattern for the Ventricular Tachyarrhythmias of Acute Myocardial Infarction Patients: A Meta-Analysis

Cardiology ◽

10.1159/000501474 ◽

2019 ◽

Vol 144 (3-4) ◽

pp. 69-75

Author(s):

Shangbo Xu ◽

Lihua Yang ◽

Danhua Hong ◽

Lan Chen ◽

Xin Wang

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Prognostic Value ◽

Meta Analysis ◽

Cochrane Library ◽

Ventricular Tachyarrhythmias ◽

Early Repolarization ◽

The Cochrane Library ◽

The Relationship

Several studies have indicated that early repolarization (ER) is a risk factor for ventricular tachyarrhythmias (VTAs) in acute myocardial infarction (AMI) patients. The prognostic values of ER detail characteristics except J-point morphology, and inferior leads ER location for VTAs are still unclear. We searched PubMed, Embase, and the Cochrane Library for eligible studies up to March 4, 2019. Studies to investigate the relationship between ER and the incidence of VTAs in AMI patients were extracted. A total of 10 studies with 2,672 participants were included in the analysis. ER significantly predicted the incidence of VTAs (odds ratio [OR] 3.62, 95% confidence intervals [CI] 2.77–4.73), regardless of the type of AMI. The presence of ER before AMI (OR 5.58, 95% CI 3.41 to 9.12) and after AMI (OR 3.02, 95% CI 2.19–4.15) increased the risk of VTAs. The prognostic value of ER for VTAs in the long follow-up (≥30 days) (OR 2.39, 95% CI 1.59–3.59) fell by half compared to the short follow-up duration (<30 days) (OR 4.97, 95% CI 3.48–7.09). Patients with ER displayed a higher risk of developing ventricular fibrillation (VF) (OR 6.94, 95% CI 3.87–12.43) than those without ER. However, neither J-point elevation with OR = 2.48 nor lateral leads’ ER location with OR = 3.83 remarkably increased the risk of VTAs in patients with AMI. ER is significantly associated with increasing risk of VTAs, particularly VF, in AMI patients. This relationship is weaker in the 30-day follow-up and is not reinforced by J-point elevation and lateral leads’ ER location.

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Incidence and risk factors of delirium after percutaneous coronary intervention in individuals hospitalised for acute myocardial infarction: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-044564 ◽

2020 ◽

Vol 10 (12) ◽

pp. e044564

Author(s):

Kaizhuang Huang ◽

Jiaying Lu ◽

Yaoli Zhu ◽

Tao Cheng ◽

Dahao Du ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Systematic Review ◽

Acute Myocardial Infarction ◽

Percutaneous Coronary Intervention ◽

Risk Factor ◽

Meta Analysis ◽

Coronary Intervention ◽

Cochrane Library ◽

Percutaneous Coronary

IntroductionDelirium in the postoperative period is a wide-reaching problem that affects important clinical outcomes. The incidence and risk factors of delirium in individuals with acute myocardial infarction (AMI) after primary percutaneous coronary intervention (PCI) has not been completely determined and no relevant systematic review and meta-analysis of incidence or risk factors exists. Hence, we aim to conduct a systematic review and meta-analysis to ascertain the incidence and risk factors of delirium among AMI patients undergoing PCI.Methods and analysesWe will undertake a comprehensive literature search among PubMed, EMBASE, Cochrane Library, PsycINFO, CINAHL and Google Scholar from their inception to the search date. Prospective cohort and cross-sectional studies that described the incidence or at least one risk factor of delirium will be eligible for inclusion. The primary outcome will be the incidence of postoperative delirium. The quality of included studies will be assessed using a risk of bias tool for prevalence studies and the Cochrane guidelines. Heterogeneity of the estimates across studies will be assessed. Incidence and risk factors associated with delirium will be extracted. Incidence data will be pooled. Each risk factor reported in the included studies will be recorded together with its statistical significance; narrative and meta-analytical approaches will be employed. The systematic review and meta-analysis will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationThis proposed systematic review and meta-analysis is based on published data, and thus there is no requirement for ethics approval. The study will provide an up to date and accurate incidence and risk factors of delirium after PCI among patients with AMI, which is necessary for future research in this area. The findings of this study will be disseminated through publication in a peer-reviewed journal.PROSPERO registration numberCRD42020184388.

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Systematic Review and Meta-Analysis of the Utility of Circular RNAs as Biomarkers of Hepatocellular Carcinoma

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2019/1684039 ◽

2019 ◽

Vol 2019 ◽

pp. 1-13 ◽

Cited By ~ 2

Author(s):

Qingqin Hao ◽

Yadi Han ◽

Wei Xia ◽

Qinghui Wang ◽

Huizhong Qian

Keyword(s):

Likelihood Ratio ◽

Meta Analysis ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Diagnostic Odds Ratio ◽

Clinicopathological Characteristics ◽

Cochrane Library ◽

Circular Rnas ◽

Clinical Value ◽

Sensitivity Specificity

Emerging studies have reported circRNAs were dysregulated in HCC. However, the clinical value of these circRNAs remains to be clarified. Herein, we aimed to comprehensively explore their association with the diagnosis, prognosis, and clinicopathological characteristics of HCC. PubMed, EMBASE, Web of Science, and Cochrane Library databases were comprehensively searched for eligible studies up to October 30, 2018. The diagnostic effect was evaluated by the pooled sensitivity, specificity, and other indexes. The pooled hazard ratio (HR) for overall survival (OS) and recurrence free survival (RFS) was calculated to assess the prognostic value. Ten studies on diagnosis, 12 on prognosis, and 23 on clinicopathology were identified from the databases. A total of 11 upregulated and 11 downregulated circRNAs showed an association with clinicopathological features of HCC. For the diagnosis analyses, the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) of circRNAs for HCC were 0.74 (95%CI: 0.65-0.82) and 0.76 (95%CI: 0.70-0.81), 3.1 (95%CI: 2.5-3.8), 0.34 (95%CI: 0.25-0.47), and 9 (95%CI: 6-14), respectively. The area under SROC curve (AUC) was 0.81 (95% CI: 0.78–0.84), indicating moderate diagnostic accuracy. In stratified analyses, the diagnostic performance of circRNAs varied based on the source of control and specimen type. For the prognosis analyses, increased expression of upregulated circRNAs was associated with worse OS (HR: 3.67, 95%: 2.07-6.48), while high expression of downregulated circRNAs was associated with better OS (HR: 0.38, 95%: 0.30-0.48). In conclusion, this study reveals that circRNAs may serve as promising diagnostic and prognostic biomarkers for HCC. However, further investigations are still required to explore the clinical value of circRNAs.

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The Accuracy of Near Infrared Autofluorescence in Identifying Parathyroid Gland During Thyroid and Parathyroid Surgery: A Meta-Analysis

Frontiers in Endocrinology ◽

10.3389/fendo.2021.701253 ◽

2021 ◽

Vol 12 ◽

Author(s):

Bin Wang ◽

Chun-Rong Zhu ◽

Hong Liu ◽

Xin-Min Yao ◽

Jian Wu

Keyword(s):

Parathyroid Gland ◽

Sensitivity And Specificity ◽

Area Under Curve ◽

Near Infrared ◽

Reference Lists ◽

Meta Analysis ◽

Cochrane Library ◽

Parathyroid Surgery ◽

Funnel Plots ◽

The Cochrane Library

ObjectiveWe aim to assess the accuracy of near infrared autofluorescence in identifying parathyroid gland during thyroid and parathyroid surgery.MethodA systematic literature search was conducted by using PubMed, Embase, and the Cochrane Library electronic databases for studies that were published up to February 2021. The reference lists of the retrieved articles were also reviewed. Two authors independently assessed the methodological quality and extracted the data. A random-effects model was used to calculate the combined variable. Publication bias in these studies was evaluated with the Deeks’ funnel plots.ResultA total of 24 studies involving 2,062 patients and 6,680 specimens were included for the meta-analysis. The overall combined sensitivity and specificity, and the area under curve of near infrared autofluorescence were 0.96, 0.96, and 0.99, respectively. Significant heterogeneities were presented (Sen: I2 = 87.97%, Spe: I2 = 65.38%). In the subgroup of thyroid surgery, the combined sensitivity and specificity, and the area under curve of near infrared autofluorescence was 0.98, 0.99, and 0.99, respectively, and the heterogeneities were moderate (Sen: I2 = 59.71%, Spe: I2 = 67.65%).ConclusionNear infrared autofluorescence is an excellent indicator for identifying parathyroid gland during thyroid and parathyroid surgery.

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Diagnostic utility of endoscopic ultrasonography-elastography in the evaluation of solid pancreatic masses: a meta-analysis and systematic review

Medical Ultrasonography ◽

10.11152/mu-987 ◽

2017 ◽

Vol 19 (2) ◽

pp. 150 ◽

Cited By ~ 7

Author(s):

Yi Lu ◽

Lu Chen ◽

Chujun Li ◽

Honglei Chen ◽

Jinhua Chen

Keyword(s):

Sensitivity And Specificity ◽

Endoscopic Ultrasonography ◽

Meta Analysis ◽

Strain Ratio ◽

Diagnostic Odds Ratio ◽

Needle Aspiration ◽

Diagnostic Methods ◽

Pancreatic Masses ◽

Comprehensive Comparison ◽

Sensitivity Specificity

Aim: The accuracy for endoscopic ultrasonography-elastography (EUS-EG) in the evaluation of solid pancreatic masses varies greatly and the pooled results have not been updated since 2013. Also, there still lack a comprehensive comparison among EUS-EG, contrast-enhanced EUS (CE-EUS), and EUS-guided fine needle aspiration (EUS-FNA).Material and methods: A thorough search was made for diagnostic trials investigating the role of EUS-EG in solid pancreatic masses. Meta-Disc was used to calculate the pooled sensitivity, specificity, diagnostic odds ratio and summary receiver operator characteristics. Results: Finally, 17 studies (1537 patients, 1544 lesions) were selected. The pooled sensitivity and specificity for qualitative methods were 0.97 (95%CI, 0.95-0.99) and 0.67 (95%CI, 0.59-0.74), respectively; the pooled sensitivity and specificity for strain histograms were 0.97 (95%CI, 0.95-0.98) and 0.67(95%CI, 0.61-0.73), respectively; the pooled sensitivity and specificity for strain ratio were 0.98 (95%CI, 0.96-0.99) and 0.62 (95%CI, 0.56-0.68), respectively; the pooled sensitivity and specificity for CE-EUS were 0.90 (95%CI, 0.83-0.95) and 0.76 (95%CI, 0.67-0.84), respectively; the pooled sensitivity and specificity for EUS-FNA were 0.84 (95%CI, 0.77-0.90) and 0.96(95%CI, 0.88-1.00), respectively. Conclusion: EUS-EG is reliable for distinguishing solid pancreatic masses; the sensitivity and specificity for different diagnostic methods were very close. Both EUS-EG and CE-EUS can be valuable complementary supplements for EUS-FNA.

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Reliability of circulating fibrinogen in the diagnosis of prosthesis-related infections: a systematic review and meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-02171-x ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Xingyang Zhu ◽

Haitao Zhang ◽

Xiaobo Sun ◽

Yijin Li ◽

Jiahao Li ◽

...

Keyword(s):

Likelihood Ratio ◽

Meta Analysis ◽

Joint Infection ◽

Area Under The Curve ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Diagnostic Odds Ratio ◽

Small Sample ◽

Cochrane Library ◽

Sensitivity Specificity

Abstract Background Fibrinogen (FIB) has recently been used as a biomarker to diagnose periprosthetic joint infection (PJI), but its reliability is still questionable. The aim of this study was to investigate the accuracy of FIB in the diagnosis of PJI after joint replacement. Methods We searched for literatures published in PubMed, EMBASE, and the Cochrane Library from the time of database inception to September 2020 and screened the studies according to the inclusion criteria. Then, we calculated the diagnostic parameters of FIB, including the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), area under the curve (AUC), and diagnostic odds ratio (DOR). In addition, we implemented subgroup analyses to identify the sources of heterogeneity. Results Seven studies including 1341 patients were selected in our meta-analysis. The pooled sensitivity, specificity, PLR, NLR, and DOR of FIB for PJI diagnosis were 0.78 (95% confidence interval [CI], 0.73–0.82), 0.83 (95% CI, 0.81–0.86), 4.60 (95% CI, 3.30–6.42), 0.24 (95% CI, 0.18–0.34), and 20.13 (95% CI, 14.80–27.36), respectively, while the AUC was 0.896. Conclusion The present study indicated that FIB was a reliable detection method and might be introduced into the diagnostic criteria for PJI. However, more robust studies are still needed to confirm the current findings, because most of the included studies were retrospective and had small sample sizes.

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The Value of Pepsinogen in GC Screening: A Systematic Review and Meta-Analysis

Gastroenterology Research and Practice ◽

10.1155/2019/7087232 ◽

2019 ◽

Vol 2019 ◽

pp. 1-11 ◽

Cited By ~ 1

Author(s):

Ling Liu ◽

Junjie Lang ◽

Yuelong Jin ◽

Yan Chen ◽

Weiwei Chang ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Meta Analysis ◽

Barium Meal ◽

Cochrane Library ◽

Likelihood Ratios ◽

Exclusion Criteria ◽

High Quality Research ◽

Wide Range ◽

The Cochrane Library

Background. The current gold standard for gastric cancer (GC) screening is pathology or a barium meal followed by X-ray. This is not applicable to a wide range of screening capabilities due to the lack of operability. This article used a meta-analysis to evaluate the value of pepsinogen (PG) screening for GC.Methods. PubMed, EMbase, the Cochrane Library, CNKI, WanFang, VIP, and CBM databases were systematically searched for published studies that used serum PG to diagnose GC. Articles were searched from January 2003 to January 2018. Two reviewers independently screened the literature according to specified inclusion and exclusion criteria. The data were extracted and evaluated, and the quality of the methodologies evaluated using the QUADAS entry. The meta-analysis (MA) was performed using Meta-DiSc 1.4 software. Stata 12.0 software was used to assess publication bias.Results. A total of 19 studies were finally included from a total of 169,009 cases. The MA showed a combined sensitivity and specificity of 0.56 (95% CI (0.53–0.59),P<0.01) and 0.71 (95% CI (0.70-0.71),P<0.01), respectively. The combined likelihood ratios were +LR = 2.82 (95% CI (2.06–3.86),P<0.01) and −LR = 0.56 (95% CI (0.45–0.68),P<0.01). The combined DOR was 5.41 (95% CI (3.64~ 8.06),P<0.01), and the area under the SROC curve was 0.7468.Conclusions. Serum PG provides medium levels of sensitivity and specificity for GC assessment. To be used in a clinical setting, further high-quality research must be performed and verified.

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Serial high-sensitivity cardiac troponin T measurements to rule out acute myocardial infarction and a single high baseline measurement for swift rule-in: A systematic review and meta-analysis

European Heart Journal Acute Cardiovascular Care ◽

10.1177/2048872618819421 ◽

2019 ◽

Vol 9 (1) ◽

pp. 14-22 ◽

Cited By ~ 5

Author(s):

M Arslan ◽

A Dedic ◽

E Boersma ◽

EA Dubois

Keyword(s):

Myocardial Infarction ◽

Systematic Review ◽

Acute Myocardial Infarction ◽

Cardiac Troponin ◽

Troponin T ◽

Meta Analysis ◽

High Sensitivity ◽

Cardiac Troponin T ◽

Single Baseline ◽

Rule Out

Aims: The purpose of this study was to determine (a) the ability of serial high-sensitivity cardiac troponin T measurements to rule out acute myocardial infarction and (b) the ability of a single high baseline high-sensitivity cardiac troponin T measurement to rule in acute myocardial infarction in patients presenting to the emergency department with acute chest pain. Methods and results: Embase, Medline, Cochrane, Web of Science and Google scholar were searched for prospective cohort studies that evaluated parameters of diagnostic accuracy of serial high-sensitivity cardiac troponin T to rule out acute myocardial infarction and a single baseline high-sensitivity cardiac troponin T value>50 ng/l to rule in acute myocardial infarction. The search yielded 21 studies for the systematic review, of which 14 were included in the meta-analysis, with a total of 11,929 patients and an overall prevalence of acute myocardial infarction of 13.0%. For rule-out, six studies presented the sensitivity of serial measurements <14 ng/l. This cut-off classified 60.1% of patients as rule-out and the summary sensitivity was 96.7% (95% confidence interval: 92.3–99.3). Three studies presented the sensitivity of a one-hour algorithm with a baseline high-sensitivity cardiac troponin T value<12 ng/l and delta 1 hour <3 ng/l. This algorithm classified 60.2% of patients as rule-out and the summary sensitivity was 98.9% (96.4–100). For rule-in, six studies reported the specificity of baseline high-sensitivity cardiac troponin T value>50 ng/l. The summary specificity was 94.6% (91.5–97.1). Conclusion: Serial high-sensitivity cardiac troponin T measurement strategies to rule out acute myocardial infarction perform well, and a single baseline high-sensitivity cardiac troponin T value>50 ng/l to rule in acute myocardial infarction has a high specificity.

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A meta-analysis of serum Hcy in diagnosis of diabetic nephropathy

Pteridines ◽

10.1515/pteridines-2020-0001 ◽

2020 ◽

Vol 31 (1) ◽

pp. 1-8

Author(s):

Xiaoling Zhou ◽

Aijie Shi ◽

Xiao Zhou

Keyword(s):

Diabetic Nephropathy ◽

Effect Size ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Diagnostic Odds Ratio ◽

Diagnostic Sensitivity ◽

Cochrane Library ◽

Statistical Heterogeneity ◽

Sensitivity Specificity

AbstractObjective This meta-analysis aims to investigate the diagnostic performance of serum homocysteine (Hcy) as a biomarker for diabetic nephropathy (DN).Methods Clinical publications relevant to serum Hcy level and DN were systematic searched in the electronic databases of; Pubmed, Cochrane Library, Embase, Web of science, CNKI and CBM. The diagnostic data from each included original study was extracted and pooled by the effect size of diagnostic sensitivity, specificity, positive likely hood ratio (+LR), negative likely hood ratio (-LR), diagnostic odds ratio (DOR) and area under the symmetric ROC curve (AUC).Results 18 publications relevant to serum Hcy and DN were included in the meta-analysis. The I2 test demonstrated significant statistical heterogeneity across the 18 studies for the effect size of diagnostic. The pooled diagnostic sensitivity, specificity, +LR, -L, DOR, AUC were 0.76 (95%CI: 0.74-0.78), 0.84 (95%CI:0.82-0.86), 5.05 (95%CI:3.52-7.24), 0.27 (95%CI:0.19-0.39), 21.68 (95% CI:11.15to 42.14) and 0.90 respectively in the random effect model.Conclusion Based on the present publications, serum Hcy is a promising serological marker for DN diagnosis.

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Comparison of diagnostic accuracy of Midkine and AFP for detecting hepatocellular carcinoma: a systematic review and meta-analysis

Bioscience Reports ◽

10.1042/bsr20192424 ◽

2020 ◽

Vol 40 (3) ◽

Cited By ~ 2

Author(s):

Qingqing Lu ◽

Jie Li ◽

Hui Cao ◽

Chenlu Lv ◽

Xiaolin Wang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Diagnostic Accuracy ◽

Hepatitis Virus ◽

Early Stage ◽

Meta Analysis ◽

Area Under The Curve ◽

Cochrane Library ◽

Sensitivity Specificity ◽

The Cochrane Library

Abstract Objective: Midkine (MDK) has been proposed as one of the most promising markers for hepatocellular carcinoma (HCC). This meta-analysis was conducted to compare the diagnostic accuracy of MDK and α-fetoprotein (AFP) for HCC. Methods: We systematically searched PubMed/MEDLINE, Ovid/EMBASE, and the Cochrane Library for all relevant studies up to 18 May 2019. The Revised Quality Assessment for Studies of Diagnostic Accuracy tool (QUADAS-2) was used to assess the methodological quality of the included studies. The sensitivity, specificity, and the area under the curve (AUC) of MDK and AFP for detecting HCC were pooled using random-effects model. Results: Seventeen studies from five articles with a total of 1122 HCC patients and 2483 controls were included. The summary estimates using MDK and AFP for detecting HCC were as follows: sensitivity, 85 vs 52%, specificity, 82 vs 94%, and AUC, 0.90 vs 0.83. The summary estimates using MDK and AFP for detecting hepatitis virus-related HCC as follows: sensitivity, 93 vs 74%, specificity, 85 vs 97%, and AUC, 0.95 vs 0.97. The summary estimates using MDK and AFP for detecting early-stage HCC were as follows: sensitivity, 83.5 vs 44.4%, specificity, 81.7 vs 84.8%, and AUC, 0.87 vs 0.52. The summary estimates using MDK for detecting AFP-negative HCC as follows: sensitivity, 88.5%, specificity, 83.9%, and AUC, 0.91. Conclusion: MDK is more accurate than AFP in diagnosing HCC, especially for early-stage HCC and AFP-negative HCC. Both MDK and AFP had excellent diagnostic performance for hepatitis virus-related HCC.

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