{{위키데이터 속성 추적}}
'''주요 심혈관 사건'''(major adverse cardiovascular events, '''MACE''') 또는 '''주요 심장 사건'''(major adverse cardiac events)은 심혈관계 연구에서 자주 사용되는 [[복합평가변수]]이다.<ref name="pmid32021362">{{저널 인용| vauthors=Bonora BM, Avogaro A, Fadini GP | title=Extraglycemic Effects of SGLT2 Inhibitors: A Review of the Evidence | journal=[[Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy]] | volume=13 | pages=161–174 | year=2020 | url= | doi = 10.2147/DMSO.S233538 | pmc=6982447 | pmid=32021362}}</ref><ref name="pmid32966719">{{저널 인용| vauthors=Chong WH, Yanoff LB, Andraca-Carrera E, Hai MT | title=Assessing the Safety of Glucose-Lowering Drugs - A New Focus for the FDA | journal=[[The New England Journal of Medicine]] | volume=383 | issue=13 | pages=1199–1202 | year=2020 | doi = 10.1056/NEJMp2004889 | pmid=32966719| s2cid=221888300 }}</ref> [[임상시험]]에서 널리 사용되는 용어이지만 MACE의 정의는 연구마다 다르게 쓰여 비슷한 연구 간의 비교를 어렵게 만들기도 한다.<ref name="pmid18279733 ">{{저널 인용| vauthors=Kip KE, Hollabaugh K, Marroquin OC, Williams DO | title=The problem with composite end points in cardiovascular studies: the story of major adverse cardiac events and percutaneous coronary intervention | journal= [[Journal of the American College of Cardiology]] | volume=51 | issue=7 | pages=701–707 | year=2008 | doi= 10.1016/j.jacc.2007.10.034 | pmid = 18279733 | doi-access=free }}</ref>

소위 말하는 "classical 3-point MACE"는 치명적이지 않은 [[뇌졸중]], 치명적이지 않은 [[심근경색]], 심혈관계 질환으로 인한 사망을 복합적으로 이르는 말이다.<ref name="pmid29037211">{{저널 인용| vauthors=de Jong M, van der Worp HB, van der Graaf Y, Visseren FL, Westerink J | title=Pioglitazone and the secondary prevention of cardiovascular disease. A meta-analysis of randomized-controlled trials | journal= [[Cardiovascular Diabetology]] | volume=16 | issue=1 | pages=134 | year=2017 | doi= 10.1186/s12933-017-0617-4 | pmc=5644073 | pmid = 29037211 }}</ref><ref name="pmid31992158">{{저널 인용|vauthors=Arnott C, Li Q, Kang A, Neuen BL, Bompoint S, Lam CS, Rodgers A, Mahaffey KW, Cannon CP, Perkovic V, Jardine MJ, Neal B | title=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= [[Journal of the American Heart Association]] | volume=9 | issue=3 | pages=e014908 | year=2020 | doi= 10.1161/JAHA.119.014908 | pmc=7033896 | pmid = 31992158 }}</ref> 다른 연구에서는 MACE를 "[[심부전]], 허혈성 심혈관질환, 심질환으로 인한 사망 등의 심혈관질환"으로 정의하기도 했다.<ref name="pmid28663251">{{저널 인용| vauthors=Heianza Y, Ma W, Manson JE, Rexrode KM, Qi L | title=Gut Microbiota Metabolites and Risk of Major Adverse Cardiovascular Disease Events and Death: A Systematic Review and Meta-Analysis of Prospective Studies | journal= [[Journal of the American Heart Association]] | volume=6 | issue=7 | pages=e004947 | year=2017 | doi= 10.1161/JAHA.116.004947 | pmc=5586261 | pmid = 28663251 }}</ref> 또 다른 연구에서는 MACE를 "심혈관질환으로 인한 사망, 심근경색이나 심부전으로 인한 입원"으로 정의했다.<ref name="pmid29897923">{{저널 인용| vauthors=Ramchand J, Patel SK, Srivastava PM, Farouque O, Burrell LM | title=Elevated plasma angiotensin converting enzyme 2 activity is an independent predictor of major adverse cardiac events in patients with obstructive coronary artery disease | journal=[[PLOS One]] | volume=13 | issue=6 | pages=e0198144 | year=2018 | doi = 10.1371/journal.pone.0198144 | pmc=5999069 | pmid=29897923| bibcode=2018PLoSO..1398144R | doi-access=free }}</ref>

몇몇 연구에서는 죽상경화성 MACE 환자에게 [[SGLT2 억제제]]가 도움이 된다고 결론을 내렸다.<ref name="pmid30424892">{{저널 인용| vauthors=Zelniker TA, Wiviott SD, abatine MS | title=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 | journal=[[The Lancet]] | volume=393 | issue=10166 | pages=31–39 | year=2019 |  doi = 10.1016/S0140-6736(18)32590-X | pmid=30424892 | s2cid=53277899 }}</ref><ref name="pmid34497814">{{저널 인용| vauthors=Xu D, Chandler O, Xiao H | title=Sodium-Glucose Cotransporter-2 Inhibitor (SGLT2i) as a Primary Preventative Agent in the Healthy Individual: A Need of a Future Randomised Clinical Trial? | journal=[[Frontiers in Medicine]] | volume=8  | pages=712671 | year=2021 |  doi = 10.3389/fmed.2021.712671 | pmc=8419219 | pmid=34497814 | doi-access=free }}</ref> 이 중 한 연구에서는 MACE를 "심근경색, 뇌졸중, 심혈관질환으로 인한 사망"으로 정의했다.<ref name="pmid30424892" />

MACE 정의가 이토록 다양하여 체계적 문헌고찰이나 메타분석 연구에 방해가 된다는 점이 계속 비판을 받아 왔다.<ref>{{저널 인용|last1=Poudel |first1=I |last2=Tejpal |first2=C |last3=Rashid |first3=H |last4=Jahan |first4=N |title=Major Adverse Cardiovascular Events: An Inevitable Outcome of ST-elevation myocardial infarction? A Literature Review. |journal=Cureus |date=30 July 2019 |volume=11 |issue=7 |pages=e5280 |doi=10.7759/cureus.5280 |pmid=31423405|s2cid=201040946 }}</ref><ref>{{저널 인용|last1=Bonsu |first1=JM |last2=Guha |first2=A |last3=Charles |first3=L |last4=Yildiz |first4=VO |last5=Wei |first5=L |last6=Baker |first6=B |last7=Brammer |first7=JE |last8=Awan |first8=F |last9=Lustberg |first9=M |last10=Reinbolt |first10=R |last11=Miller |first11=ED |last12=Jneid |first12=H |last13=Ruz |first13=P |last14=Carter |first14=RR |last15=Milks |first15=MW |last16=Paskett |first16=ED |last17=Addison |first17=D |title=Reporting of Cardiovascular Events in Clinical Trials Supporting FDA Approval of Contemporary Cancer Therapies. |journal=Journal of the American College of Cardiology |date=18 February 2020 |volume=75 |issue=6 |pages=620–628 |doi=10.1016/j.jacc.2019.11.059 |pmid=32057377}}</ref><ref>{{저널 인용|last1=Bosco |first1=E |last2=Hsueh |first2=L |last3=McConeghy |first3=KW |last4=Gravenstein |first4=S |last5=Saade |first5=E |title=Major adverse cardiovascular event definitions used in observational analysis of administrative databases: a systematic review. |journal=BMC Medical Research Methodology |date=6 November 2021 |volume=21 |issue=1 |pages=241 |doi=10.1186/s12874-021-01440-5 |pmid=34742250|s2cid=243767377 }}</ref>

== 각주 ==
{{각주}}

{{토막글|의학}}

[[분류:심장혈관계]]