Prevalence, incidence and comparative meta-analysis of all-cause and specific-cause cardiovascular disease in patients with serious mental illness

Patients with severe mental illness (SMI) have been described at higher risk of cardiovascular disease (CVD). The aim of this systematic review and meta-analysis was to quantify prevalence, incidence, cross-sectional association and longitudinal increased risk of coronary heart disease (CHD), stroke, transient ischemic attack and cerebrovascular disease (CBVD), heart failure (HF), peripheral vascular disease (PVD), death due to CVD, and any CVD in patients with SMI. We included 92 studies, with a total population of 3,371,461 patients (BD = 241,226, MDD = 476,102, SCZ = 1,721,586, SMI = 932,547) and 113,925,577 controls. Pooled prevalence of any CVD in SMI was 9.9% (95% CI = 7.4–13.3) (33 studies, 360,144 patients). Compared to controls, after adjusting for a median of 7 confounders, SMI was associated with higher risk of CVD in cross-sectional studies, OR:1.53 (95% CI = 1.27–1.83) (11 studies), with CHD OR: 1.51 (95% CI = 1.47–1.55) (5 studies), with CBVD OR: 1.42 (95% CI = 1.21–1.66) (6 studies), and tended to be associated with HF OR: 1.28 (95% CI = 0.99–1.65) (4 studies). Cumulative incidence was 3.6 CVD events in a median follow-up period of 8.4 years (range: 1.76–30). After considering a median of 6 confounders, SMI was associated with higher longitudinal risk of CVD in longitudinal studies HR: 1.78 (95% CI = 1.6, 1.98) (31 studies), of CHD: HR: 1.54 (95% CI 1.30–1.82) (18 studies), of CBVD HR: 1.64 (95% CI 1.26–2.14) (11 studies), of HF HR:2.10 (95% CI 1.64–2.70) (2 studies), of PVD, unadjusted RR: 3.11 (95% CI 2.46–3.91) (3 studies), of death due to CVD, HR 1.85 (95% CI 1.53–2.24) (16 studies). In this meta-analysis, the association between SMI and CVD has been quantified in a world representative sample; we suggest prevention of CVD should be warranted as standard care in SMI.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Psychological distress among healthcare providers during COVID-19 in Asia: Systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0257983 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0257983

Author(s):

Siew Mooi Ching ◽

Kar Yean Ng ◽

Kai Wei Lee ◽

Anne Yee ◽

Poh Ying Lim ◽

...

Keyword(s):

Meta Analysis ◽

Healthcare Providers ◽

Random Effects Model ◽

Depression And Anxiety ◽

Cross Sectional ◽

Funnel Plot ◽

Health And Wellbeing ◽

Pooled Prevalence ◽

Increased Risk ◽

Prevalence Of Depression

Introduction COVID-19 pandemic is having a devastating effect on the mental health and wellbeing of healthcare providers (HCPs) globally. This review is aimed at determining the prevalence of depression, anxiety, stress, fear, burnout and resilience and its associated factors among HCPs in Asia during the COVID-19 pandemic. Material and methods We performed literature search using 4 databases from Medline, Cinahl, PubMed and Scopus from inception up to March 15, 2021 and selected relevant cross-sectional studies. Publication bias was assessed using funnel plot. Random effects model was used to estimate the pooled prevalence while risk factors were reported in odds ratio (OR) with 95% CI. Results We included 148 studies with 159,194 HCPs and the pooled prevalence for depression was 37.5% (95%CI: 33.8–41.3), anxiety 39.7(95%CI: 34.3–45.1), stress 36.4% (95%CI: 23.2–49.7), fear 71.3% (95%CI: 54.6–88.0), burnout 68.3% (95%CI: 54.0–82.5), and low resilience was 16.1% (95%CI: 12.8–19.4), respectively. The heterogeneity was high (I2>99.4%). Meta-analysis reported that both females (OR = 1.48; 95% CI = 1.30–1.68) and nurses (OR = 1.21; 95%CI = 1.02–1.45) were at increased risk of having depression and anxiety [(Female: OR = 1.66; 95% CI = 1.49–1.85), (Nurse: OR = 1.36; 95%CI = 1.16–1.58)]. Females were at increased risk of getting stress (OR = 1.59; 95%CI = 1.28–1.97). Conclusion In conclusion, one third of HCPs suffered from depression, anxiety and stress and more than two third of HCPs suffered from fear and burnout during the COVID-19 pandemic in Asia.

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Gallstone Disease and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Observational Studies

Scandinavian Journal of Surgery ◽

10.1177/1457496916650998 ◽

2016 ◽

Vol 106 (1) ◽

pp. 21-27 ◽

Cited By ~ 10

Author(s):

S. Upala ◽

A. Sanguankeo ◽

V. Jaruvongvanich

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Cardiovascular Disease ◽

Confidence Interval ◽

Cardiovascular Events ◽

Meta Analysis ◽

Gallstone Disease ◽

Hazard Ratio ◽

Cross Sectional ◽

Increased Risk

Objectives: Gallstone disease shares certain risk factors with cardiovascular disease, particularly metabolic risk factors. Patients with gallstone disease may be at increased risk of cardiovascular disease. Several recent studies exploring the effect of gallstone disease on cardiovascular disease outcomes demonstrated inconsistent results. Design: We conducted a systematic review and meta-analysis of cohort, case–control, and cross-sectional studies that compared the risk of developing cardiovascular disease events in patients with gallstone disease versus non-gallstone disease controls. Data from each study were combined using the random-effects, generic inverse variance method of DerSimonian and Laird to calculate the pooled hazard ratio, odd ratio, and 95% confidence interval. Results: Data were extracted from six studies involving 176,734 cases and 803,714 controls. The pooled hazard ratio of cardiovascular events in patients with gallstone disease was 1.28 (95% confidence interval: 1.23–1.33, I2 = 42%). The pooled odd ratio of cardiovascular events in patients with gallstone disease was 1.82 (95% confidence interval: 1.47–2.24, I2 = 68%). Conclusions: Our study demonstrated a statistically significant increase in the risk of cardiovascular disease among patients with gallstone disease.

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The prevalence of cardiovascular disease in Ethiopia: a systematic review and meta-analysis of institutional and community-based studies

BMC Cardiovascular Disorders ◽

10.1186/s12872-020-01828-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Dessie Abebaw Angaw ◽

Rahma Ali ◽

Afework Tadele ◽

Shegaye Shumet

Keyword(s):

Cardiovascular Disease ◽

General Population ◽

Meta Analysis ◽

Group Analysis ◽

Premature Death ◽

Design Quality ◽

Cross Sectional ◽

Mesh Terms ◽

Pooled Prevalence ◽

Significant Difference

Abstract Background Worldwide cardiovascular disease is the major cause of disability and premature death. This is due to the ascending trend of consuming an unhealthy diet and obesity which increases the risk of hypertension and type 2 diabetes mellitus. Thus this study aimed to determine the pooled prevalence of the cardiovascular disease in Ethiopia. Methods Medline, Scopus, and Google Scholar search engines were accessed using medical subject heading (MeSH) terms for studies based in Ethiopia, from 2000 to 2018. However, studies done among a specific group of the population were excluded from the study. Data were extracted by one reviewer and then checked independently by a second reviewer. Studies were qualitatively synthesis in terms of design, quality, study population, outcomes, and result. Sub-group analysis and sensitivity tests were conducted to identify potential influences on the prevalence estimates. Quantitative results were pooled in a statistical meta-analysis using STATA version 14 software. Result Nine eligible cross-sectional studies were included in the analysis. The prevalence ranges from 1 to 20%. The pooled prevalence of cardiovascular disease (CVD) was 5% (95% CI: 3–8%). The prevalence was higher in the population who visits hospitals, 8% (95% CI: 4–12%) compared to the general population, 2% (95% CI: 1–5%). There was no significant difference in the overall prevalence of CVD between males and females. Conclusion The prevalence of cardiovascular disease was high. A higher prevalence of CVD was found among patients who visited health institutions than the general population and no observed significant sex difference in the prevalence

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Abstract 17412: Vital Exhaustion and Incident Cardiovascular Disease: a Meta-Analysis

Circulation ◽

10.1161/circ.130.suppl_2.17412 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Jincy Thankachen ◽

Chirag Bavishi ◽

Randy Cohen ◽

Alan Rozanski

Keyword(s):

Cardiovascular Disease ◽

Risk Factor ◽

Prospective Studies ◽

Meta Analysis ◽

Significant Risk ◽

Cvd Risk ◽

Vital Exhaustion ◽

Increased Risk ◽

Psychosocial Conditions

Background: A number of psychosocial conditions are associated with cardiovascular disease (CVD) events. One such condition is vital exhaustion (VE), defined as a combination of fatigue, increased irritability and feelings of demoralization. To date, a number of studies have examined the association between VE, fatigue (as a stand-alone entity) and subsequent cardiovascular events with varying results. In order to evaluate the potency of VE/fatigue as a CVD risk factor, we conducted a meta-analysis of existing studies concerning these factors in the literature. Methods: A systematic search of PubMed, EMBASE and PsychINFO (1972-May, 2014) was performed to identify all prospective studies involving subjects without baseline CVD, investigating the relationship between VE/fatigue and incident CVD. Unadjusted and adjusted effect estimates were extracted from individual studies. Pooled effect estimates were calculated with DerSimonian and Laird random effects models. Results: Eleven prospective studies with a total of 60, 610 participants and a mean follow-up period of 6.5 years were included in the analysis. A significant association was observed between VE/fatigue and incident CVD, using both unadjusted estimates [Pooled Relative Risk: 1.69 (CI: 1.31-2.18), p<0.001] and adjusted estimates from individual studies [Pooled RR: 1.36 (CI: 1.14-1.63), p=0.001]. Subgroup analysis by years of follow-up and type of VE/fatigue questionnaire yielded similar increased risk of incident CVD. Conclusions: VE/fatigue is a significant risk factor for incident CVD in healthy subjects, comparable in potency to some of the other common psychosocial risk factors for cardiac disease.

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POS1131 THE INCIDENCE AND PREVALENCE OF CARDIOVASCULAR DISEASES IN GOUT: A SYSTEMATIC REVIEW AND META-ANALYSIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.1425 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 844.2-845

Author(s):

P. Cox ◽

S. Gupta ◽

S. S. Zhao ◽

D. Hughes

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Venous Thromboembolism ◽

Cardiovascular Diseases ◽

Cerebrovascular Accident ◽

Meta Analysis ◽

Pooled Prevalence ◽

Increased Risk

Background:Gout is an inflammatory crystal arthropathy characterised by hyperuricaemia and sodium urate crystal deposition. Both gout and subclinical hyperuricaemia are associated with adverse cardiovascular outcomes. Several studies have found gout to cause an increased risk of cardiovascular disease, but the evidence is not unanimous. The conflicting evidence has made it difficult to establish the extent of the cardiovascular risk to patients with gout.Objectives:To describe the incidence and prevalence of cardiovascular disease in gout, compare these results with non-gout controls.Methods:PubMed, Scopus and Web of Science were systematically searched in January 2021 for studies reporting prevalence of any cardiovascular disease in a gout population. Studies with non-representative sampling, where a cohort had been used in another study, small sample size (< 100) and where gout could not be distinguished from other rheumatic conditions were excluded. Sample size, prevalence of the investigated cardiovascular disease, definition of gout and cardiovascular disease, demographic data, data source and any comparisons with non-gout controls were extracted from each study. Where prevalence data was reported in ≥3 cohorts meta-analysis was performed using random-effect models.Results:Of the 6164 titles identified, 105 full texts were assessed for eligibility with 30 included in the review, producing a gout population of 1,125,988. Pooled prevalence estimates were calculated for six cardiovascular diseases: heart failure (8.73%; 95% confidence interval (CI), 2.85 – 23.76), cerebrovascular accident (4.27%; 95% CI, 1.83 – 9.67), myocardial infarction (2.82%; 95% CI, 1.58 – 5.01), venous thromboembolism (2.05%; 95% CI, 1.22 – 3.43), hypertension (63.94%; 95% CI, 24.51 – 90.64) and cardiovascular mortality (4.75%; 95% CI, 3.56 – 6.31). Twenty studies reported comparisons with non-gout controls, illustrating an increased risk in the gout group across all cardiovascular diseases, particularly for myocardial infarction.Conclusion:Cardiovascular diseases are more prevalent in patients with gout and should prompt vigilance from clinicians to the need to assess and stratify cardiovascular risk. These results are in line with other studies which have shown an increased cardiovascular risk for sufferers of hyperuricaemia, highlighting the need for future research to explain this finding. There are limited studies in the literature investigating less common cardiovascular conditions, illustrating the need for future work if a more thorough picture of prevalence is to be established.Figure 1.Forest plots of pooled prevalence of: (A) 8.73% for heart failure, (B) 4.27% for cerebrovascular accident, (C) 2.82% for myocardial infarction, (D) 2.05% for venous thromboembolism, (E) 63.94% for hypertension and (F) 4.75% for cardiovascular mortality.Disclosure of Interests:None declared.

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306 - Loneliness and mortality in older adults and the role of depression

International Psychogeriatrics ◽

10.1017/s1041610220002069 ◽

2020 ◽

Vol 32 (S1) ◽

pp. 64-64

Author(s):

T.J. Holwerda ◽

D. Rhebergen ◽

H.C. Comijs ◽

J.J.M. Dekker ◽

M.L. Stek

Keyword(s):

Cardiovascular Disease ◽

Older Adults ◽

Mortality Risk ◽

Meta Analysis ◽

Clinical Perspective ◽

Cross Sectional ◽

Mediating Role ◽

Underlying Mechanisms ◽

Dexamethasone Suppression

Background:The prevalence of loneliness increases with age. The presence of loneliness in older adults has been found to be associated with health problems such as depression, decreased cognitive functioning, increases in systolic blood pressure and increased mortality. The underlying mechanisms of the higher mortality risk are largely unknown.Methods:Meta-analysis to investigate the present evidence for the associations between loneliness and mortality. Cross-sectional studies investigating the associations between loneliness and cardiovascular disease and between loneliness and cortisol in 378 depressed and 132 non-depressed older adults.Results:Loneliness appears to be associated with increased mortality, although when only studies are included that consider depression as a covariate, the association is not significant. Therefore it seems likely that depression plays a mediating role in the higher mortality risk.We did not find a significant association between loneliness and cardiovascular disease. In contrast, loneliness was significantly associated with lower cortisol output and decreased dexamethasone suppression.Discussion:The results and their implications for prevention and treatment will be discussed from a clinical perspective as well as a general health perspective. Is loneliness as potentially dangerous as depression?

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The incidence and prevalence of cardiovascular diseases in gout: a systematic review and meta-analysis

Rheumatology International ◽

10.1007/s00296-021-04876-6 ◽

2021 ◽

Author(s):

Peter Cox ◽

Sonal Gupta ◽

Sizheng Steven Zhao ◽

David M. Hughes

Keyword(s):

Systematic Review ◽

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Cardiovascular Diseases ◽

Small Sample Size ◽

Meta Analysis ◽

Random Effect ◽

Small Sample ◽

Future Research ◽

Increased Risk

AbstractThe aims of this systematic review and meta-analysis were to describe prevalence of cardiovascular disease in gout, compare these results with non-gout controls and consider whether there were differences according to geography. PubMed, Scopus and Web of Science were systematically searched for studies reporting prevalence of any cardiovascular disease in a gout population. Studies with non-representative sampling, where a cohort had been used in another study, small sample size (< 100) and where gout could not be distinguished from other rheumatic conditions were excluded, as were reviews, editorials and comments. Where possible meta-analysis was performed using random-effect models. Twenty-six studies comprising 949,773 gout patients were included in the review. Pooled prevalence estimates were calculated for five cardiovascular diseases: myocardial infarction (2.8%; 95% confidence interval (CI)s 1.6, 5.0), heart failure (8.7%; 95% CI 2.9, 23.8), venous thromboembolism (2.1%; 95% CI 1.2, 3.4), cerebrovascular accident (4.3%; 95% CI 1.8, 9.7) and hypertension (63.9%; 95% CI 24.5, 90.6). Sixteen studies reported comparisons with non-gout controls, illustrating an increased risk in the gout group across all cardiovascular diseases. There were no identifiable reliable patterns when analysing the results by country. Cardiovascular diseases are more prevalent in patients with gout and should prompt vigilance from clinicians to the need to assess and stratify cardiovascular risk. Future research is needed to investigate the link between gout, hyperuricaemia and increased cardiovascular risk and also to establish a more thorough picture of prevalence for less common cardiovascular diseases.

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Prediction of all-cause mortality with malnutrition assessed by controlling nutritional status score in patients with heart failure: a systematic review and meta-analysis

Public Health Nutrition ◽

10.1017/s1368980021002470 ◽

2021 ◽

pp. 1-8

Author(s):

Huiyang Li ◽

Peng Zhou ◽

Yikai Zhao ◽

Huaichun Ni ◽

Xinping Luo ◽

...

Keyword(s):

Heart Failure ◽

Systematic Review ◽

Nutritional Status ◽

Meta Analysis ◽

Predictive Values ◽

Increased Risk ◽

Patients With Heart Failure ◽

All Cause Mortality ◽

Conut Score

Abstract Objective: The aim of this meta-analysis was to investigate the association between malnutrition assessed by the controlling nutritional status (CONUT) score and all-cause mortality in patients with heart failure. Design: Systematic review and meta-analysis. Settings: A comprehensively literature search of PubMed and Embase databases was performed until 30 November 2020. Studies reporting the utility of CONUT score in prediction of all-cause mortality among patients with heart failure were eligible. Patients with a CONUT score ≥2 are grouped as malnourished. Predictive values of the CONUT score were summarized by pooling the multivariable-adjusted risk ratios (RR) with 95 % CI for the malnourished v. normal nutritional status or per point CONUT score increase. Participants: Ten studies involving 5196 patients with heart failure. Results: Malnourished patients with heart failure conferred a higher risk of all-cause mortality (RR 1·92; 95 % CI 1·58, 2·34) compared with the normal nutritional status. Subgroup analysis showed the malnourished patients with heart failure had an increased risk of in-hospital mortality (RR 1·78; 95 % CI 1·29, 2·46) and follow-up mortality (RR 2·01; 95 % CI 1·58, 2·57). Moreover, per point increase in CONUT score significantly increased 16% risk of all-cause mortality during the follow-up. Conclusions: Malnutrition defined by the CONUT score is an independent predictor of all-cause mortality in patients with heart failure. Assessment of nutritional status using CONUT score would be helpful for improving risk stratification of heart failure.

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Prevalence of Depression among Healthcare Workers during the COVID-19 Outbreak: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10153406 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3406

Author(s):

Beatriz Olaya ◽

María Pérez-Moreno ◽

Juan Bueno-Notivol ◽

Patricia Gracia-García ◽

Isabel Lasheras ◽

...

Keyword(s):

Systematic Review ◽

Healthcare Workers ◽

Mental Health Problems ◽

Meta Analysis ◽

Medical Doctors ◽

Cross Sectional ◽

Random Effects Models ◽

Pooled Prevalence ◽

Prevalence Of Depression ◽

Common Mental Health Problems

Background: There is evidence of a high psychological toll from the COVID-19 pandemic in healthcare workers. This paper was aimed at conducting a systematic review and meta-analysis of studies reporting levels of depression among healthcare workers during the COVID-19 and estimating the pooled prevalence of depression. Methods: We searched for cross-sectional studies listed on PubMed from 1 December 2019 to 15 September 2020 that reported prevalence of depression in healthcare workers, nurses, medical doctors, and COVID-19 frontline professionals. The pooled proportions of depression were calculated with random effects models. Results: We identified 57 studies from seventeen countries. The pooled prevalence of depression in healthcare workers was 24% (95% CI: 20%−28%), 25% for nurses (95% CI: 18%−33%), 24% for medical doctors (95% CI: 16%−31%), and 43% for frontline professionals (95% CI: 28%−59%). Conclusions: The proportion of depression in nurses and medical doctors during the COVID-19 pandemic was similar to that found in the general population as previously reported in other meta-analyses conducted with smaller numbers of studies. Importantly, almost half of the frontline healthcare workers showed increased levels of depression. There is need for a comprehensive, international response to prevent and treat common mental health problems in healthcare workers.

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Incremental changes in QRS duration as predictor for cardiovascular disease: a 21-year follow-up of a randomly selected general population

Scientific Reports ◽

10.1038/s41598-021-93024-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Xiaojing Chen ◽

Per-Olof Hansson ◽

Erik Thunström ◽

Zacharias Mandalenakis ◽

Kenneth Caidahl ◽

...

Keyword(s):

Cardiovascular Disease ◽

General Population ◽

Cardiovascular Events ◽

Population Sample ◽

Cox Regression Analysis ◽

Major Cardiovascular Events ◽

Increased Risk ◽

Qrs Duration ◽

Group 1

AbstractThe QRS complex has been shown to be a prognostic marker in coronary artery disease. However, the changes in QRS duration over time, and its predictive value for cardiovascular disease in the general population is poorly studied. So we aimed to explore if increased QRS duration from the age of 50–60 is associated with increased risk of major cardiovascular events during a further follow-up to age 71. A random population sample of 798 men born in 1943 were examined in 1993 at 50 years of age, and re-examined in 2003 at age 60 and 2014 at age 71. Participants who developed cardiovascular disease before the re-examination in 2003 (n = 86) or missing value of QRS duration in 2003 (n = 127) were excluded. ΔQRS was defined as increase in QRS duration from age 50 to 60. Participants were divided into three groups: group 1: ΔQRS < 4 ms, group 2: 4 ms ≤ ΔQRS < 8 ms, group 3: ΔQRS ≥ 8 ms. Endpoints were major cardiovascular events. And we found compared with men in group 1 (ΔQRS < 4 ms), men with ΔQRS ≥ 8 ms had a 56% increased risk of MACE during follow-up to 71 years of age after adjusted for BMI, systolic blood pressure, smoking, hyperlipidemia, diabetes and heart rate in a multivariable Cox regression analysis (HR 1.56, 95% CI:1.07–2.27, P = 0.022). In conclusion, in this longitudinal follow-up over a decade QRS duration increased in almost two out of three men between age 50 and 60 and the increased QRS duration in middle age is an independent predictor of major cardiovascular events.

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