Association between kidney stones and risk of developing stroke: a meta-analysis

Abstract Background Many studies have described the relationship between kidney stones and stroke, but the results are controversial, so we conducted this meta-analysis to estimate the relationship between kidney stones and the risk of developing stroke. Methods Studies were marked with a comprehensive search of PubMed, EMBASE, Google, and ISI Web of Science databases through 25 March 2020. Hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted, and a random-effects model or fix-effects model was used to compute the pooled combined risk estimate. Heterogeneity was reported as I2. We performed subgroup and sensitivity analysis to assess potential sources of heterogeneity. Results Eight studies of seven articles involving 3,526,808 participants were included in the meta-analysis. Overall, kidney stones were associated with a moderate risk of stroke incidence (HR, 1.24; 95% CI, 1.11–1.40; I2=79.6%; p=0.000). We conducted a sensitivity analysis by removing the studies that had a high risk of bias. Heterogeneity subsequently decreased significantly, while an increased risk of stroke in patient with kidney stones was again demonstrated (HR, 1.16; 95% CI, 1.11–1.23; I2=28.7%; p=0.000). Stratifying analysis showed that the results were more pronounced for ischemic stroke (HR, 1.14; 95% CI, 1.08–1.22; I2=15.6%; p=0.00) and the follow-up duration ≥10 years (HR, 1.18; 95% CI, 1.10–1.27; I2=31.6%; p=0.003). Conclusions Our meta-analysis suggests that patients with kidney stones may have a modestly increased risk of developing stroke, especially in ischemic stroke. More large-scaled and clinical trials should be done to identify the relative impact of kidney stones on stroke outcomes in the future.

Download Full-text

Abstract 13315: Long-term Risk of Cardiovascular Events Following Hospitalization for Sepsis: A Systematic Review and Meta-analysis

Circulation ◽

10.1161/circ.142.suppl_3.13315 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Leah B Kosyakovsky ◽

Federico Angriman ◽

Emma Katz ◽

Neill Adhikari ◽

Lucas C Godoy ◽

...

Keyword(s):

Systematic Review ◽

Cumulative Incidence ◽

Meta Analysis ◽

Hazard Ratios ◽

Increased Risk ◽

Significant Difference ◽

Sepsis Survivors ◽

Risk Ratios

Introduction: Sepsis results in dysregulated inflammation, coagulation, and metabolism, which may contribute to increased cardiovascular disease (CVD) risk. We conducted a systematic review and meta-analysis to determine the association between sepsis and subsequent long-term CVD events. Methods: MEDLINE, Embase, and the Cochrane Controlled Trials Register and Database of Systematic Reviews were searched from inception to May 2020 to identify observational studies of adult sepsis survivors (defined by diagnostic codes or consensus definitions) measuring long-term CV outcomes. The primary outcome was a composite of myocardial infarction, CV death, and stroke. Random-effects models estimated the pooled cumulative incidence and adjusted hazard ratios of CV events relative to hospital or population controls. Odds ratios were included as risk ratios assuming <10% incidence in non-septic controls, and risk ratios were taken as hazard ratios (HR) assuming no censoring. Outcomes were analyzed at maximum follow-up (primary analysis) and stratified by time (<1 year, 1-2 years, and >2 years) since sepsis. Results: Of 11,235 abstracts screened, 25 studies (22 cohort studies, 2 case-crossover studies, and 1 case-control) involving 1,949,793 sepsis survivors were included. The pooled cumulative incidence of CVD events was 9% (95% CI; 5-14%). Sepsis was associated with an increased risk (HR 1.59, 95% CI 1.37-1.86) of CVD events at maximum follow-up ( Figure ); between-study heterogeneity was substantial (I 2 =97.3%). There was no significant difference when comparing studies using population and hospital controls. Significantly elevated risk was observed up to 5 years following sepsis. Conclusions: Sepsis survivors experience an approximately 50% increased risk of CVD events, which may persist for years following the index episode. These results highlight a potential unmet need for early cardiac risk stratification and optimization in sepsis survivors.

Download Full-text

Association of Cancer and the Risk of Developing Atrial Fibrillation: A Systematic Review and Meta-Analysis

Cardiology Research and Practice ◽

10.1155/2019/8985273 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Ming Yuan ◽

Zhiwei Zhang ◽

Gary Tse ◽

Xiaojin Feng ◽

Panagiotis Korantzopoulos ◽

...

Keyword(s):

Atrial Fibrillation ◽

Systematic Review ◽

Cancer Diagnosis ◽

Meta Analysis ◽

Solid Cancer ◽

Hazard Ratios ◽

Increased Risk ◽

The Relationship ◽

Onset Atrial Fibrillation ◽

Embolic Risk

Aims. Previous studies have demonstrated epidemiological evidence for an association between cancer and the development of new-onset atrial fibrillation (AF). However, these results have been conflicting. This systematic review and meta-analysis was conducted to examine the relationship between cancer and the risk of developing atrial fibrillation. Methods. PubMed and Web of Science were searched for publications examining the association between cancer and atrial fibrillation risk published until June 2017. Adjusted odds ratios (ORs) or hazard ratios (HRs) and 95% CI were extracted and pooled. Results. A total of five studies involving 5,889,234 subjects were included in this meta-analysis. Solid cancer patients are at higher risk developing atrial fibrillation compared to noncancer patients (OR 1.47, 95% CI 1.31 to 1.66, p<0.00001; I2 = 67%, p=0.02). The risk of atrial fibrillation was highest within 90 days of cancer diagnosis (OR 7.62, 95% CI 3.08 to 18.88, p<0.00001) and this risk diminished with time. Conclusions. The risk of AF was highest within 90 days of cancer diagnosis. We should take into account the increased risk of atrial fibrillation development and, after this, study the embolic risk and potential indication of oral anticoagulation.

Download Full-text

Relationship of Obstructive Sleep Apnoea with Diabetic Retinopathy: A Meta-Analysis

BioMed Research International ◽

10.1155/2017/4737064 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 7

Author(s):

Zhenliu Zhu ◽

Fengying Zhang ◽

Yunxia Liu ◽

Shuqin Yang ◽

Chunting Li ◽

...

Keyword(s):

Diabetes Mellitus ◽

Sensitivity Analysis ◽

Diabetic Retinopathy ◽

Publication Bias ◽

Meta Analysis ◽

Sleep Apnoea ◽

Obstructive Sleep ◽

Increased Risk ◽

Relationship Of ◽

The Relationship

Until now, the relationship of obstructive sleep apnoea (OSA) with diabetic retinopathy (DR) was controversial. This meta-analysis was performed to obtain definitive conclusion on this topic. Relevant articles were searched on databases of Pubmed, Google Scholar, and Chinese National Knowledge Infrastructure (CNKI). The articles were selected according to inclusion and exclusion criteria. Odds ratio (OR) with 95% confidence interval (CI) was used to evaluate the relationship of OSA with risk of DR.I2andPvalue were used to assess the presence of heterogeneity.I2≥ 50% orP<0.05indicated significant heterogeneity. Sensitivity analysis was performed to evaluate the robustness of pooled results. Begg’s funnel plot and Egger’s regression analysis were adopted to assess publication bias. 6 eligible studies were selected in the present meta-analysis. The pooled results indicated that OSA was significantly associated with increased risk of DR (OR = 2.01, 95% CI = 1.49–2.72). Subgroup analysis based on type of diabetes mellitus suggested that OSA was related to DR in both Type 1 and Type 2 diabetes mellitus. Sensitivity analysis demonstrated that pooled results were robust. No significant publication bias was observed (P=0.128). The results indicate that OSA is related to increased risk of DR.

Download Full-text

Relationship of lycopene intake and consumption of tomato products to incident CVD

British Journal Of Nutrition ◽

10.1017/s0007114512005417 ◽

2013 ◽

Vol 110 (3) ◽

pp. 545-551 ◽

Cited By ~ 54

Author(s):

Paul F. Jacques ◽

Asya Lyass ◽

Joseph M. Massaro ◽

Ramachandran S. Vasan ◽

Ralph B. D'Agostino Sr

Keyword(s):

Repeated Measures ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Supporting Evidence ◽

Inverse Association ◽

Cvd Risk ◽

Stroke Incidence ◽

Hazard Ratios ◽

Increased Risk

Evidence for cardioprotective effects of lycopene is inconsistent. Studies of circulating lycopene generally report inverse associations with CVD risk, but studies based on lycopene intake do not. The failure of dietary studies to support the findings based on biomarkers may be due in part to misclassification of lycopene intakes. To address this potential misclassification, we used repeated measures of intake obtained over 10 years to characterise the relationship between lycopene intake and the incidence of CVD (n314), CHD (n171) and stroke (n99) in the Framingham Offspring Study. Hazard ratios (HR) for incident outcomes were derived from Cox proportional hazards regression models using logarithmically transformed lycopene intake adjusted for CVD risk factors and correlates of lycopene intake. HR were interpreted as the increased risk for a 2·7-fold difference in lycopene intake, a difference approximately equal to its interquartile range. Using an average of three intake measures with a 9-year follow-up, lycopene intake was inversely associated with CVD incidence (HR 0·83, 95 % CI 0·70, 0·98). Using an average of two intake measures and 11 years of follow-up, lycopene intake was inversely associated with CHD incidence (HR 0·74, 95 % CI 0·58, 0·94). Lycopene intake was unrelated to stroke incidence. The present study of lycopene intake and CVD provides supporting evidence for an inverse association between lycopene and CVD risk; however, additional research is needed to determine whether lycopene or other components of tomatoes, the major dietary source of lycopene, are responsible for the observed association.

Download Full-text

Effects of ANRIL variants on the risk of ischemic stroke: a meta-analysis

Bioscience Reports ◽

10.1042/bsr20182127 ◽

2019 ◽

Vol 39 (5) ◽

Cited By ~ 1

Author(s):

Cheng Tan ◽

Junzhi Liu ◽

Jun Wei ◽

Shoujun Yang

Keyword(s):

Ischemic Stroke ◽

Confidence Intervals ◽

Meta Analysis ◽

Recessive Model ◽

Individual Susceptibility ◽

Non Coding Rna ◽

Increased Risk ◽

Subgroup Analyses ◽

The Relationship ◽

Allele Model

Abstract Background : Several studies investigated the relationship between antisense non-coding RNA in the INK4 locus (ANRIL) variants and the risk of ischemic stroke (IS), yet whether ANRIL variants are associated with IS remain controversial. Therefore, we performed the present study to obtain a more conclusive result. Methods: Literature retrieval was conducted in PubMed, Medline and Embase. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results: Eighteen studies were enrolled for analyses. Pooled overall analyses showed that rs2383206 (recessive model: P=0.002, OR = 1.22, 95%CI 1.08–1.38; allele model: P=0.003, OR = 0.90, 95%CI 0.84–0.96) and rs10757274 (allele model: P=0.006, OR = 0.91, 95%CI 0.86–0.97) variants were significantly associated with an increased risk of IS. Further subgroup analyses by ethnicity revealed that rs2383206, rs10757274 and rs10757278 variants were all significantly correlated with an increased risk of IS in Asians. Additionally, rs10757278 polymorphism was also significantly correlated with an increased risk of IS in Caucasians. Conclusions: Our findings indicated that rs2383206, rs10757274 and rs10757278 variants may impact individual susceptibility to IS in Asians. Moreover, rs10757278 polymorphism may also impact individual susceptibility to IS in Caucasians.

Download Full-text

The Association of Atrial Fibrillation and Ischemic Stroke in Patients on Hemodialysis: A Competing Risk Analysis

Canadian Journal of Kidney Health and Disease ◽

10.1177/2054358119878719 ◽

2019 ◽

Vol 6 ◽

pp. 205435811987871 ◽

Cited By ~ 4

Author(s):

Mark Findlay ◽

Rachael MacIsaac ◽

Mary Joan MacLeod ◽

Wendy Metcalfe ◽

Manish M. Sood ◽

...

Keyword(s):

Atrial Fibrillation ◽

Ischemic Stroke ◽

Stroke Risk ◽

Competing Risk ◽

Discharge Data ◽

Stroke Incidence ◽

Risk Of Death ◽

Hazards Model ◽

The Relationship

Background: Stroke is common in patients with end-stage renal disease (ESRD) treated with hemodialysis (HD) and associated with high mortality rate. In the general population, atrial fibrillation (AF) is a major risk factor for stroke and therapeutic anticoagulation is associated with risk reduction, whereas in ESRD the relationship is less clear. Objective: The purpose of this study is to demonstrate the influence of AF on stroke rates and probability in those on HD following competing risk analyses. Design: A national record linkage cohort study. Setting: All renal and stroke units in Scotland, UK. Patients: All patients with ESRD receiving HD within Scotland from 2005 to 2013 (follow-up to 2015). Measurements: Demographic, clinical, and laboratory data were linked between the Scottish Renal Registry, Scottish Stroke Care Audit, and hospital discharge data. Stroke was defined as a fatal or nonfatal event and mortality derived from national records. Methods: Associations for stroke were determined using competing risk models: the cause-specific hazards model and the Fine and Gray subdistribution hazards model accounting for the competing risk of death in models of all stroke, ischemic stroke, and first-ever stroke. Results: Of 5502 patients treated with HD with 12 348.6-year follow-up, 363 (6.6%) experienced stroke. The stroke incidence rate was 26.7 per 1000 patient-years. Multivariable regression on the cause-specific hazard for stroke demonstrated age, hazard ratio (HR) (95% confidence interval [CI]) = 1.04 (1.03-1.05); AF, HR (95% CI) = 1.88 (1.25-2.83); prior stroke, HR (95% CI) = 2.29 (1.48-3.54), and diabetes, HR (95% CI) = 1.92 (1.45-2.53); serum phosphate, HR (95% CI) = 2.15 (1.56-2.99); lower body weight, HR (95% CI) = 0.99 (0.98-1.00); lower hemoglobin, HR (95% CI) = 0.88 (0.77-0.99); and systolic blood pressure (BP), HR (95% CI) = 1.01 (1.00-1.02), to be associated with an increased stroke rate. In contrast, the subdistribution HRs obtained following Fine and Gray regression demonstrated that AF, weight, and hemoglobin were not associated with stroke risk. In both models, AF was significantly associated with nonstroke death. Limitations: Our analyses derive from retrospective data sets and thus can only describe association not causation. Data on anticoagulant use are not available. Conclusions: The incidence of stroke in HD patients is high. The competing risk of “prestroke” mortality affects the relationship between AF and risk of future stroke. Trial designs for interventions to reduce stroke risk in HD patients, such as anticoagulation for AF, should take account of competing risks affecting associations between risk factors and outcomes.

Download Full-text

The MicroRNAs as Prognostic Biomarkers for Survival in Esophageal Cancer: A Meta-Analysis

The Scientific World JOURNAL ◽

10.1155/2014/523979 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 14

Author(s):

Wenbo Fu ◽

Lijuan Pang ◽

Yunzhao Chen ◽

Lan Yang ◽

Janbo Zhu ◽

...

Keyword(s):

Esophageal Cancer ◽

Meta Analysis ◽

Prognostic Role ◽

Time Restrictions ◽

Hazard Ratios ◽

Mirnas Expression ◽

Design And Methods ◽

The Relationship

Objectives.We performed this meta-analysis to summarize all the results from available studies, aiming delineating the prognostic role of miRNA in esophageal cancer.Design and Methods. We searched the electronic databases PubMed, EMBASE, and ISI Web of Science without time restrictions for the correlative literature to aggregate the survival results. Relevant data were extracted from studies investigating the relationship between miRNAs expression and survival in esophageal cancer patients. Pooled hazard ratios of miR-21and miR-375 for OS in ESCC were calculated.Results.A total of 25 studies involving 2,258 subjects analyzed the relationship between miRNA and prognosis of EC. In all, thirty-nine miRNAs associated with prognosis were reported in these studies. The pooled HR of higher miR-21 expression compared with lower miR-21 expression in ESCC was 1.84 (95% CI: 1.41–2.40,P<0.001), which could significantly predict poorer OS in ESCC. Besides, higher miR-375 was also a significant predictor for OS in ESCC, with a pooled HR of 0.55 (95% CI: 0.42–0.72,P<0.001).Conclusions.Our results support that miR-21 and miR-375 have a prognostic role in ESCC and may be useful therapeutic targets for the treatment of ESCC and meticulous follow-up for early detection of recurrence.

Download Full-text

Effect of Digoxin Therapy on Mortality in Patients With Atrial Fibrillation: An Updated Meta-Analysis

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.731135 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xiaoxu Wang ◽

Yi Luo ◽

Dan Xu ◽

Kun Zhao

Keyword(s):

Atrial Fibrillation ◽

Meta Analysis ◽

Cochrane Library ◽

Clinical Effects ◽

Hazard Ratios ◽

Risk Of Mortality ◽

Increased Risk ◽

All Cause Mortality ◽

The Cochrane Library

Background: Whether digoxin is associated with increased mortality in atrial fibrillation (AF) remains controversial. We aimed to assess the risk of mortality and clinical effects of digoxin use in patients with AF.Methods: PubMed, Embase, and the Cochrane library were systematically searched to identify eligible studies comparing all-cause mortality of patients with AF taking digoxin with those not taking digoxin, and the length of follow-up was at least 6 months. Hazard ratios (HRs) with 95% confidence intervals (CIs) were extracted and pooled.Results: A total of 29 studies with 621,478 patients were included. Digoxin use was associated with an increased risk of all-cause mortality in all patients with AF (HR 1.17, 95% CI 1.13–1.22, P < 0.001), especially in patients without HF (HR 1.28, 95% CI 1.11–1.47, P < 0.001). There was no significant association between digoxin and mortality in patients with AF and HF (HR 1.06, 95% CI 0.99–1.14, P = 0.110). In all patients with AF, regardless of concomitant HF, digoxin use was associated with an increased risk of sudden cardiac death (SCD) (HR 1.40, 95% CI 1.23–1.60, P < 0.001) and cardiovascular (CV) mortality (HR 1.27, 95% CI 1.08–1.50, P < 0.001), and digoxin use had no significant association with all-cause hospitalization (HR 1.13, 95% CI 0.92–1.39, P = 0.230).Conclusion: We conclude that digoxin use is associated with an increased risk of all-cause mortality, CV mortality, and SCD, and it does not reduce readmission for AF, regardless of concomitant HF. Digoxin may have a neutral effect on all-cause mortality in patients with AF with concomitant HF.Systematic Review Registration:https://www.crd.york.ac.ukPROSPERO.

Download Full-text

Abstract MP78: Progression of Valvular Calcification and Risk of Incident Stroke: The Multi-ethnic Study of Atherosclerosis (MESA)

Circulation ◽

10.1161/circ.141.suppl_1.mp78 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Oluwaseun Fashanu ◽

Anas Bizanti ◽

Ahmad Al-Abdouh ◽

Di Zhao ◽

Matthew J Budoff ◽

...

Keyword(s):

Ischemic Stroke ◽

Stroke Risk ◽

Cox Regression ◽

The United States ◽

Cvd Risk ◽

Valvular Calcification ◽

Hazard Ratios ◽

Increased Risk ◽

Annular Calcification

Introduction: Stroke is a leading cause of morbidity and mortality in the United States. Identification of individuals at risk for stroke is important for implementation of preventive therapies. Prevalent valvular calcification (VC) has been shown to be associated with stroke but less is known about associations of VC progression with stroke. Methods: Progression (interval increase >0 Agatston units/year) of aortic valvular calcification (AVC) and mitral annular calcification (MAC) was assessed by two cardiac CTs over a median of 2.4 years. We determined the risk of adjudicated total and ischemic stroke using Cox regression adjusted for cardiovascular disease (CVD) risk factors. Results: We studied 5,606 multiethnic participants (39.6% White, 26.9% Black, 21.4% Hispanic, 12.2% Chinese) free of baseline CVD enrolled in MESA. Baseline mean ± SD age was 62 ± 10 years; 53% were women; 12% had prevalent AVC and 9% prevalent MAC at the baseline visit; 83% had no progression of VC, 14%, progression at one site (AVC or MAC), and 3% progression at both sites (AVC and MAC) at follow-up. Over a median of 12 years, 214 total and 170 ischemic strokes occurred. The number of sites with VC progression (range 0-2) was not associated with total and ischemic stroke (all p>0.05). We found MAC progression to be associated with increased risk of total stroke [adjusted hazard ratios (95% CI) 1.59 (1.11 - 2.27)] and ischemic stroke [1.64 (1.10 - 2.43)] in the whole cohort (model 3) and after further adjustment for baseline coronary artery calcification (model 4) ( Table ). Results remained significant for total stroke risk after excluding participants with interim atrial fibrillation or coronary heart disease [1.60 (1.01 - 2.54)]. In women, AVC progression was associated with ischemic stroke [1.87 (1.04 - 3.36)] (p-for-interaction=0.03). Conclusion: Progression of MAC over 2.4 years is associated with increased risk of total and ischemic stroke, and in women, AVC progression with higher ischemic stroke risk.

Download Full-text

Serum level of IL-10 and IL-10-1082G/A polymorphism are associated with the risk of ischemic stroke: A meta-analysis

10.21203/rs.2.21934/v1 ◽

2020 ◽

Author(s):

Xiaodong Rui ◽

Yeqin Sha ◽

Shuang Wen ◽

Qingyang Sun ◽

Jingming Hu ◽

...

Keyword(s):

Ischemic Stroke ◽

Serum Level ◽

Ethnic Groups ◽

Meta Analysis ◽

Interleukin 10 ◽

Case Control Studies ◽

Chinese Han ◽

Increased Risk ◽

Newcastle Ottawa Scale ◽

The Relationship

Abstract BACKGROUND Stroke is one of the leading causes of disability and mortality among adults worldwide. The aim of the study was to confirm the relationship of serum interleukin-10 (IL-10) and its gene polymorphism with the risk of ischemic stroke (IS). METHODS PubMed and China Wanfang database were systematically searched up to September 2, 2019. Studies illustrating on the association between serum IL-10 or IL-10-1082G/A, IL-10-819C/T, IL-10- 592C/A polymorphisms and IS susceptibility were included in this study. Newcastle–Ottawa scale was used to assess the study quality. RevMan 5.3 was used for statistical analysis. RESULTS: Seventeen case-control studies were included in this meta-analysis which provides 3754 patients with IS and 5064 controls. Combined analysis indicated that patients with IS had lower serum level of IL-10 (Mean difference [MD]: -4.25; 95% confidence interval [CI]: -6.14 to -2.36, p<0.0001). An association was identified between IL-10-1082G/A polymorphism and the risk of IS, but no association was found between polymorphism of IL-10-819C/T or IL-10- 592C/A and the risk of IS when all ethnic groups were considered together. For IL-10-1082G/A polymorphism, individuals with AA-genotype might have an increased risk of IS among Chinese Han population while no such correlation was observed in other ethnic group. CONCLUSION This meta-analysis suggested that low serum level of IL-10 and IL-10-1082G/A polymorphism may be associated with the risk of IS. More clinical studies should be conducted to confirm the relationship between serum IL-10 level and the risk of IS in all ethnic groups.

Download Full-text