주요 심혈관 사건

주요 심혈관 사건(major adverse cardiovascular events, MACE) 또는 주요 심장 사건(major adverse cardiac events)은 심혈관계 연구에서 자주 사용되는 복합평가변수이다.[1][2] 임상시험에서 널리 사용되는 용어이지만 MACE의 정의는 연구마다 다르게 쓰여 비슷한 연구 간의 비교를 어렵게 만들기도 한다.[3]

소위 말하는 "classical 3-point MACE"는 치명적이지 않은 뇌졸중, 치명적이지 않은 심근경색, 심혈관계 질환으로 인한 사망을 복합적으로 이르는 말이다.[4][5] 다른 연구에서는 MACE를 "심부전, 허혈성 심혈관질환, 심질환으로 인한 사망 등의 심혈관질환"으로 정의하기도 했다.[6] 또 다른 연구에서는 MACE를 "심혈관질환으로 인한 사망, 심근경색이나 심부전으로 인한 입원"으로 정의했다.[7]

몇몇 연구에서는 죽상경화성 MACE 환자에게 SGLT2 억제제가 도움이 된다고 결론을 내렸다.[8][9] 이 중 한 연구에서는 MACE를 "심근경색, 뇌졸중, 심혈관질환으로 인한 사망"으로 정의했다.[8]

MACE 정의가 이토록 다양하여 체계적 문헌고찰이나 메타분석 연구에 방해가 된다는 점이 계속 비판을 받아 왔다.[10][11][12]

각주

  1. ↑ Bonora BM, Avogaro A, Fadini GP (2020). “Extraglycemic Effects of SGLT2 Inhibitors: A Review of the Evidence”. 《Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy》 13: 161–174. doi:10.2147/DMSO.S233538. PMC 6982447. PMID 32021362. 
  2. ↑ Chong WH, Yanoff LB, Andraca-Carrera E, Hai MT (2020). “Assessing the Safety of Glucose-Lowering Drugs - A New Focus for the FDA”. 《The New England Journal of Medicine》 383 (13): 1199–1202. doi:10.1056/NEJMp2004889. PMID 32966719. S2CID 221888300. 
  3. ↑ Kip KE, Hollabaugh K, Marroquin OC, Williams DO (2008). “The problem with composite end points in cardiovascular studies: the story of major adverse cardiac events and percutaneous coronary intervention”. 《Journal of the American College of Cardiology》 51 (7): 701–707. doi:10.1016/j.jacc.2007.10.034. PMID 18279733. 
  4. ↑ de Jong M, van der Worp HB, van der Graaf Y, Visseren FL, Westerink J (2017). “Pioglitazone and the secondary prevention of cardiovascular disease. A meta-analysis of randomized-controlled trials”. 《Cardiovascular Diabetology》 16 (1): 134. doi:10.1186/s12933-017-0617-4. PMC 5644073. PMID 29037211. 
  5. ↑ Arnott C, Li Q, Kang A, Neuen BL, Bompoint S, Lam CS, Rodgers A, Mahaffey KW, Cannon CP, Perkovic V, Jardine MJ, Neal B (2020). “Sodium-Glucose Cotransporter 2 Inhibition for the Prevention of Cardiovascular Events in Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis”. 《Journal of the American Heart Association》 9 (3): e014908. doi:10.1161/JAHA.119.014908. PMC 7033896. PMID 31992158. 
  6. ↑ Heianza Y, Ma W, Manson JE, Rexrode KM, Qi L (2017). “Gut Microbiota Metabolites and Risk of Major Adverse Cardiovascular Disease Events and Death: A Systematic Review and Meta-Analysis of Prospective Studies”. 《Journal of the American Heart Association》 6 (7): e004947. doi:10.1161/JAHA.116.004947. PMC 5586261. PMID 28663251. 
  7. ↑ Ramchand J, Patel SK, Srivastava PM, Farouque O, Burrell LM (2018). “Elevated plasma angiotensin converting enzyme 2 activity is an independent predictor of major adverse cardiac events in patients with obstructive coronary artery disease”. 《PLOS One》 13 (6): e0198144. Bibcode:2018PLoSO..1398144R. doi:10.1371/journal.pone.0198144. PMC 5999069. PMID 29897923. 
  8. ↑ 가 나 Zelniker TA, Wiviott SD, abatine MS (2019). “SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials”. 《The Lancet》 393 (10166): 31–39. doi:10.1016/S0140-6736(18)32590-X. PMID 30424892. S2CID 53277899. 
  9. ↑ Xu D, Chandler O, Xiao H (2021). “Sodium-Glucose Cotransporter-2 Inhibitor (SGLT2i) as a Primary Preventative Agent in the Healthy Individual: A Need of a Future Randomised Clinical Trial?”. 《Frontiers in Medicine》 8: 712671. doi:10.3389/fmed.2021.712671. PMC 8419219. PMID 34497814. 
  10. ↑ Poudel, I; Tejpal, C; Rashid, H; Jahan, N (2019년 7월 30일). “Major Adverse Cardiovascular Events: An Inevitable Outcome of ST-elevation myocardial infarction? A Literature Review.”. 《Cureus》 11 (7): e5280. doi:10.7759/cureus.5280. PMID 31423405. S2CID 201040946. 
  11. ↑ Bonsu, JM; Guha, A; Charles, L; Yildiz, VO; Wei, L; Baker, B; Brammer, JE; Awan, F; Lustberg, M; Reinbolt, R; Miller, ED; Jneid, H; Ruz, P; Carter, RR; Milks, MW; Paskett, ED; Addison, D (2020년 2월 18일). “Reporting of Cardiovascular Events in Clinical Trials Supporting FDA Approval of Contemporary Cancer Therapies.”. 《Journal of the American College of Cardiology》 75 (6): 620–628. doi:10.1016/j.jacc.2019.11.059. PMID 32057377. 
  12. ↑ Bosco, E; Hsueh, L; McConeghy, KW; Gravenstein, S; Saade, E (2021년 11월 6일). “Major adverse cardiovascular event definitions used in observational analysis of administrative databases: a systematic review.”. 《BMC Medical Research Methodology》 21 (1): 241. doi:10.1186/s12874-021-01440-5. PMID 34742250. S2CID 243767377. 
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