Resting heart rate and the risk of cardiovascular disease, total cancer, and all-cause mortality – A systematic review and dose–response meta-analysis of prospective studies

AbstractObjectiveHigh Na intake has been associated with different health problems. However, serious controversies exist over studies investigating associations of Na intake with mortality from all-causes and CVD. The present systematic review and meta-analysis was done to investigate, for the first time, the dose–response association of dietary Na intake with all-cause and CVD mortality among prospective studies.DesignRelevant papers published up to August 2017 were searched in MEDLINE, EMBASE and Google Scholar databases. Prospective cohort studies on the association of dietary Na intake with all-cause or/and CVD mortality were included. Linear and non-linear dose–response associations between Na intake and CVD and all-cause mortality were examined.ResultsOverall, twenty publications met inclusion criteria. A significant non-linear association (P<0·001) was found between Na intake and CVD mortality risk among studies assessing urinary Na excretion, with a relatively steep slope at Na intakes above 2400mg/d. However, the association was not significant in studies using dietary Na intake (P=0·61). Additionally, the non-linear association of Na intake with all-cause mortality was also non-significant. No linear association (effect size; 95 % CI; I2) was seen between 100mg/d increment in Na intake and CVD mortality (1·01; 0·97, 1·05; 98·4 %) or all-cause mortality (1·01; 1·00, 1·02; 89·2 %). Following subgroup analyses, the association between Na intake and CVD mortality was observed only among studies conducted in the USA (0·99; 0·99, 1·00; 20·0 %).ConclusionsThe study showed a direct association between urinary Na excretion and CVD mortality which was more considerable at intakes above 2400mg/d. In contrast, no significant association was found between Na intake and all-cause mortality. Further long-term prospective studies on different populations are required to confirm these findings.

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Metabolically healthy obesity and risk of cardiovascular disease, cancer, and all-cause and cause-specific mortality: a protocol for a systematic review and meta-analysis of prospective studies

BMJ Open ◽

10.1136/bmjopen-2019-032742 ◽

2019 ◽

Vol 9 (10) ◽

pp. e032742 ◽

Cited By ~ 2

Author(s):

Simiao Tian ◽

Yazhuo Liu ◽

Ao Feng ◽

Keli Lou ◽

Huimin Dong

Keyword(s):

Systematic Review ◽

Cardiovascular Disease ◽

Prospective Studies ◽

Data Extraction ◽

Meta Analysis ◽

Adjusted Relative Risk ◽

Benign Condition ◽

Specific Mortality ◽

Total Cancer ◽

Metabolically Healthy

IntroductionMetabolically healthy obese phenotype (MHO) refers to obese individuals with an adequate metabolic profile and absence of metabolic syndrome. Many prospective studies have reported the benign condition relating the MHO phenotype and its potential role in reducing risk of cardiovascular disease, total cancer, and all-cause and cause-specific mortality. However, inconsistent results were found and the question remains controversial. We aim to conduct a systematic review and meta-analysis to clarify the associations these associations from relevant prospective studies.Methods and analysisThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols 2015 statement was used to prepare this protocol. MEDLINE, Web of Science databases, EMBASE and Cochrane Database will be used for literature search from their inception up to December 2019 with restriction of published studies in English. Published prospective studies reporting adjusted relative risk (RR) estimates for the association between MHO phenotype and cardiovascular disease, total cancer, all-cause or cause-specific mortality will be included. The process of study screening, selection and data extraction will be performed independently by two reviewers, and the risk of bias for the studies included will be assessed using the Newcastle-Ottawa Quality Assessment Scale. HRs or RRs for disease events and mortality with 95% CIs will be considered as primary outcomes, and summary HRs/RRs will be pooled using random-effects models. The Cochrane’s Q and the I2statistics will be used to assess and quantify heterogeneity, respectively. Subgroup analysis will also be carried out according to study characteristics to investigate potential sources of heterogeneity.Ethics and disseminationAs this meta-analysis is performed based on the published studies, no ethical approval and patient safety considerations are required. The findings of the study will be reported and submitted to a peer-reviewed journals for publication.PROSPERO registration numberCRD42019121766.

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Primary sclerosing cholangitis and the risk of cancer, cardiovascular disease, and all-cause mortality: a systematic review and meta-analysis of cohort studies

Scientific Reports ◽

10.1038/s41598-021-90175-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Dagfinn Aune ◽

Abhijit Sen ◽

Teresa Norat ◽

Elio Riboli ◽

Trine Folseraas

Keyword(s):

Colorectal Cancer ◽

Systematic Review ◽

Cardiovascular Disease ◽

Cohort Studies ◽

Sclerosing Cholangitis ◽

Meta Analysis ◽

Hepatobiliary Cancer ◽

All Cause Mortality ◽

Total Cancer ◽

Risk Of Cancer

AbstractA diagnosis of primary sclerosing cholangitis (PSC) has been associated with increased risk of hepatobiliary cancers, colorectal cancer and all-cause mortality in several studies, while associations with cardiovascular disease have been inconsistent. We conducted a systematic review and meta-analysis of published cohort studies on the topic to summarize these associations. PubMed and Embase databases were searched up to January 13th, 2020. Cohort studies on PSC and risk of cancer, cardiovascular disease, or mortality were included. Summary relative risks (RRs) and 95% confidence intervals (95% CIs) were estimated using random effects models. The summary RR (95% CI) comparing persons with PSC to persons without PSC was 584.37 (269.42–1267.51, I2 = 89%, n = 4) for cholangiocarcinoma (CCA), 155.54 (125.34–193.02, I2 = 0%, n = 3) for hepatobiliary cancer, 30.22 (11.99–76.17, I2 = 0%, n = 2) for liver cancer, 16.92 (8.73–32.78, I2 = 88%, n = 4) for gastrointestinal cancer, 7.56 (2.42–23.62, I2 = 0%, n = 3) for pancreatic cancer, 6.10 (4.19–8.87, I2 = 14%, n = 7) for colorectal cancer (CRC), 4.13 (2.99–5.71, I2 = 80%, n = 5) for total cancer, 3.55 (2.94–4.28, I2 = 46%, n = 5) for all-cause mortality, and 1.57 (0.25–9.69, I2 = 79%, n = 2) for cardiovascular disease. Strong positive associations were observed between PSC and risk of CCA, hepatobiliary cancer, liver cancer, gastrointestinal cancer, pancreatic cancer, CRC, total cancer, and all-cause mortality, but not for cardiovascular disease.

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Dose–response effect of postprocedural elevated cardiac troponin level on adverse clinical outcomes following adult noncardiac surgery: a systematic review protocol of prospective studies

BMJ Open ◽

10.1136/bmjopen-2020-046223 ◽

2021 ◽

Vol 11 (6) ◽

pp. e046223

Author(s):

Tao An ◽

Yue Tian ◽

Jingfei Guo ◽

Wenying Kang ◽

Tao Tian ◽

...

Keyword(s):

Systematic Review ◽

Dose Response ◽

Prospective Studies ◽

Cardiac Troponin ◽

Meta Analysis ◽

Noncardiac Surgery ◽

Systematic Review Protocol ◽

All Cause Mortality ◽

Review Protocol

IntroductionMyocardial injury after noncardiac surgery has been recognised as an important complication associated with short-term and long-term morbidity and mortality. However, whether a higher level of postoperative cardiac troponin (cTn) is associated with a higher incidence of major complications remains controversial. Hence, we will conduct a comprehensive dose–response meta-analysis based on all relevant prospective studies to quantitatively evaluate the association between elevated postoperative cTn levels and short-/long-term adverse clinical outcomes following adult noncardiac surgery.MethodsWe will search the PubMed, EMBase, Cochrane Library, ISI Knowledge via Web of Science, China National Knowledge Infrastructure, Wanfang and VIP databases (from inception until October 2020) to identify all prospective cohort studies using the relevant keywords. The primary outcome will be all-cause mortality. The secondary outcomes will include cardiovascular mortality and major adverse cardiovascular events (MACEs). Univariable or multivariable meta-regression and subgroup analyses will be conducted for the comparison between elevated versus nonelevated categories of postoperative cTn levels. Sensitivity analyses will be used to assess the robustness of our results by removing each included study at one time to obtain and evaluate the remaining overall estimates of all-cause mortality or MACE. To conduct a dose–response meta-analysis for the potential linear or restricted cubic spline regression relationship between postoperative elevated cTn levels and all-cause mortality or MACE, studies with three or more categories will be included.Ethics and disseminationEthical approval is waived for the systematic review protocol according to the Institutional Review Board/Independent Ethics Committee of Fuwai Hospital. This meta-analysis will be disseminated through a peer-reviewed journal for publication and conference presentations.PROSPERO registration numberCRD42020173175.

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Incidence, risk factors and prognostic effect of imaging right ventricular involvement in patients with COVID-19: a dose–response analysis protocol for systematic review

BMJ Open ◽

10.1136/bmjopen-2021-049866 ◽

2021 ◽

Vol 11 (5) ◽

pp. e049866

Author(s):

Chenghui Zhou ◽

Baohui Lou ◽

Hui Li ◽

Xin Wang ◽

Hushan Ao ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Right Ventricular ◽

Dose Response ◽

Meta Analysis ◽

Adult Patients ◽

Sensitivity Analyses ◽

Prognostic Effect ◽

All Cause Mortality ◽

Incidence Risk

IntroductionEmerging evidence has shown that COVID-19 infection may result in right ventricular (RV) disturbance and be associated with adverse clinical outcomes. The aim of this meta-analysis is to summarise the incidence, risk factors and the prognostic effect of imaging RV involvement in adult patients with COVID-19.MethodsA systematical search will be performed in PubMed, EMBase, ISI Knowledge via Web of Science and preprint databases (MedRxiv and BioRxiv) (until October 2021) to identify all cohort studies in adult patients with COVID-19. The primary outcome will be the incidence of RV involvement (dysfunction and/or dilation) assessed by echocardiography, CT or MRI. Secondary outcomes will include the risk factors for RV involvement and their association with all-cause mortality during hospitalisation. Additional outcomes will include the RV global or free wall longitudinal strain (RV-GLS or RV-FWLS), tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC) and RV diameter. Univariable or multivariable meta-regression and subgroup analyses will be performed for the study design and patient characteristics (especially acute or chronic pulmonary embolism and pulmonary hypertension). Sensitivity analyses will be used to assess the robustness of our results by removing each included study at one time to obtain and evaluate the remaining overall estimates of RV involvement incidence and related risk factors, association with all-cause mortality, and other RV parameters (RV-GLS or RV-FWLS, TAPSE, S’, FAC and RV diameter). Both linear and cubic spline regression models will be used to explore the dose–response relationship between different categories (>2) of RV involvement and the risk of mortality (OR or HR).Ethics and disseminationThere was no need for ethics approval for the systematic review protocol according to the Institutional Review Board/Independent Ethics Committee of Fuwai Hospital. This meta-analysis will be disseminated through a peer-reviewed journal for publication.PROSPERO registration numberCRD42021231689.

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