心脏型脂肪酸结合蛋白在急性冠脉综合征患者中的预后价值：一项系统综述与荟萃分析。
完整摘要 · 中文译文
引言：心脏型脂肪酸结合蛋白（H-FABP）在心肌损伤后迅速释放，但其在急性冠脉综合征（ACS）中的预后意义仍不确定。我们评估了在确诊或疑似ACS中H-FABP升高与不良临床结局之间的关联。 方法：检索了PubMed、Embase、CENTRAL、Web of Science和Scopus，时间从建库至2026年8月30日，无日期限制。纳入评估循环H-FABP在确诊或疑似ACS成人中诊断和/或预后相关性的研究。预后结局包括全因死亡率、主要不良心血管事件（MACE）、心力衰竭（HF）相关住院和复发性心肌梗死（MI）。使用QUIPS评估偏倚风险。使用限制最大似然估计的逆方差随机效应模型合并可提取的2 × 2事件数据中的粗比值比（OR）。 结果：共纳入12项研究，其中5项纳入荟萃分析。H-FABP升高与全因死亡率（OR 5.68；95% CI 3.98–8.09；I² = 30%）、MACE（OR 4.56；95% CI 1.97–10.55；I² = 47%）、HF相关住院（OR 4.29；95% CI 2.94–6.26；I² = 0%）和复发性MI（OR 1.65；95% CI 1.15–2.37；I² = 0%）的更高几率相关。合并估计值未经调整；7项研究采用叙述性综合。 结论：H-FABP升高与ACS的不良结局相关，但当前证据并未确立其独立的预后价值。进一步的前瞻性研究应确定H-FABP是否增加预后预测价值。 超出既定的临床和生化风险标志物的预测价值。
完整摘要 · 英文原文
INTRODUCTION: Heart-type fatty acid-binding protein (H-FABP) is rapidly released following myocardial injury, but its prognostic significance in acute coronary syndrome (ACS) remains uncertain. We evaluated the association between elevated H-FABP and adverse clinical outcomes in confirmed or suspected ACS. METHODS: PubMed, Embase, CENTRAL, Web of Science and Scopus were searched from inception to 30 August 2026 without date restriction. Studies assessing diagnostic and/or prognostic relevance of circulating H-FABP in adults with confirmed or suspected ACS were eligible. Prognostic outcomes included all-cause mortality, major adverse cardiovascular events (MACE), heart failure (HF)-related hospitalisation and recurrent myocardial infarction (MI). Risk of bias was assessed using QUIPS. Crude odds ratios (ORs) from extractable 2 × 2 event data were pooled using inverse-variance random-effects models with restricted maximum-likelihood estimation. RESULTS: Twelve studies were included, with five contributing to meta-analysis. Elevated H-FABP was associated with higher odds of all-cause mortality (OR 5.68; 95% CI 3.98-8.09; I2 = 30%), MACE (OR 4.56; 95% CI 1.97-10.55; I2 = 47%), HF-related hospitalisation (OR 4.29; 95% CI 2.94-6.26; I2 = 0%) and recurrent MI (OR 1.65; 95% CI 1.15-2.37; I2 = 0%). Pooled estimates were unadjusted; seven studies were synthesised narratively. CONCLUSION: Elevated H-FABP is associated with adverse outcomes in ACS, but current evidence does not establish independent prognostic value. Further prospective studies should determine whether H-FABP adds predictive value beyond established clinical and biochemical risk markers.