scholarly journals Association of β-blocker use with survival and pulmonary function in patients with chronic obstructive pulmonary and cardiovascular disease: a systematic review and meta-analysis

2020 ◽  
Vol 41 (46) ◽  
pp. 4415-4422 ◽  
Author(s):  
Yan-Li Yang ◽  
Zi-Jian Xiang ◽  
Jing-Hua Yang ◽  
Wen-Jie Wang ◽  
Zhi-Chun Xu ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Forced Expiratory Volume ◽  
Cochrane Library ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The Difference

Abstract Aims The aim of this study was to clarify the effect of β-blockers (BBs) on respiratory function and survival in patients with chronic obstructive pulmonary disease with cardiovascular disease (CVD), as well as the difference between the effects of cardioselective and noncardioselective BBs. Methods and results We searched for relevant literature in four electronic databases, namely, PubMed, EMBASE, Cochrane Library, and Web of Science, and compared the differences in various survival indicators between patients with chronic obstructive pulmonary disease taking BBs and those not taking BBs. Forty-nine studies were included, with a total sample size of 670 594. Among these, 12 studies were randomized controlled trials (RCTs; seven crossover and five parallel RCTs) and 37 studies were observational (including four post hoc analyses of data from RCTs). The hazard ratios (HRs) of chronic obstructive pulmonary disease exacerbation between patients with chronic obstructive pulmonary disease who were not treated with BBs and those who were treated with BBs, cardioselective BBs, and noncardioselective BBs were 0.77 [95% confidence interval (CI) 0.67, 0.89], 0.72 [95% CI 0.56, 0.94], and 0.98 [95% CI 0.71, 1.34, respectively] (HRs <1 indicate favouring BB therapy). The HRs of all-cause mortality between patients with chronic obstructive pulmonary disease who were not treated with BBs and those who were treated with BBs, cardioselective BBs, and noncardioselective BBs were 0.70 [95% CI 0.59, 0.83], 0.60 [95% CI 0.48, 0.76], and 0.74 [95% CI 0.60, 0.90], respectively (HRs <1 indicate favouring BB therapy). Patients with Chronic obstructive pulmonary disease treated with cardioselective BBs showed no difference in ventilation effect after the use of an agonist, in comparison with placebo. The difference in mean change in forced expiratory volume in 1 s was 0.06 [95% CI −0.02, 0.14]. Conclusion The use of BBs in patients with chronic obstructive pulmonary disease is not only safe but also reduces their all-cause and in-hospital mortality. Cardioselective BBs may even reduce chronic obstructive pulmonary disease exacerbations. In addition, cardioselective BBs do not affect the action of bronchodilators. Importantly, BBs reduce the heart rate acceleration caused by bronchodilators. BBs should be prescribed freely when indicated in patients with chronic obstructive pulmonary disease and heart disease.

scholarly journals Blood eosinophil count-guided corticosteroid therapy and as a prognostic biomarker of exacerbations of chronic obstructive pulmonary disease: a systematic review and meta-analysis

2021 ◽  
Vol 12 ◽  
pp. 204062232110287
Author(s):  
Tao Liu ◽  
Zi-Jian Xiang ◽  
Xiao-Meng Hou ◽  
Jing-Jing Chai ◽  
Yan-Li Yang ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Prognostic Biomarker ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
The Stability

Background: Chronic obstructive pulmonary disease (COPD) is characterized by persistent respiratory symptoms and dyspnea, as well as an increase in the number of leukocytes in the airways, lungs, and pulmonary vessels. A ‘One size fits all’ approach to COPD patients with different clinical features may be considered outdated. The following are the two major objectives of this meta-analysis: the first is to determine if blood eosinophil counts (BEC) can serve as a prognostic biomarker of COPD outcomes, and the second is to determine which level of BEC is effective for inhaled corticosteroid (ICS) treatment. Methods: We searched articles published before 15 May 2021 in the following four electronic databases: Web of Science, Cochrane Library, EMBASE, and PubMed. Results: A total of 42 studies, comprising a sampling of 188,710 subjects, were summarized and compared in this meta-analysis. The rate ratio (RR) of exacerbations of COPD (ECOPD) between ICS and non-ICS treatment was statistically significant for the COPD patients with a baseline BEC ⩾ 2% or ⩾ 200 cells/μl, RR = 0.82 (0.73, 0.93) or 0.79 (0.70, 0.89) respectively, while the RR of ECOPD between ICS and non-ICS treatment was statistically insignificant for the COPD patients with baseline BEC < 2% or <200 cells/μl, RR = 0.97 (0.87, 1.08) or 0.97 (0.86, 1.08), suggested that ICS therapy was beneficial to the improvement of ECOPD in patients with a baseline BEC ⩾ 2% or BEC ⩾ 200 cells/μl. Conclusion: Our research shows that a BEC ⩾ 200 cells/μl or ⩾2% is likely to become the cutoff value of ICS treatment for ECOPD. Moreover, we believe that the baseline BEC can be used as a biomarker for predicting ECOPD. The stability of BEC requires special attention.

scholarly journals Serum Albumin Concentrations in Stable Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (2) ◽  
pp. 269
Author(s):  
Elisabetta Zinellu ◽  
Alessandro G. Fois ◽  
Elisabetta Sotgiu ◽  
Sabrina Mellino ◽  
Arduino A. Mangoni ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Obstructive Pulmonary Disease ◽  
Serum Albumin ◽  
Pulmonary Disease ◽  
Meta Analysis ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Standard Mean Difference ◽  
Copd Patients

Background: Chronic obstructive pulmonary disease (COPD) is a progressive condition characterized by chronic airway inflammation and lung parenchyma damage. Systemic inflammation and oxidative stress also play a role in the pathogenesis of COPD. Serum albumin is a negative acute-phase protein with antioxidant effects and an important marker of malnutrition. The aim of this meta-analysis was to investigate differences in serum albumin concentrations between patients with stable COPD and non-COPD subjects. Methods: A systematic search was conducted, using the terms “albumin” and “chronic obstructive pulmonary disease” or “COPD”, in the electronic databases PubMed and Web of Science, from inception to May 2020. Results: Twenty-six studies were identified on a total of 2554 COPD patients and 2055 non-COPD controls. Pooled results showed that serum albumin concentrations were significantly lower in COPD patients (standard mean difference, SMD = −0.50, 95% CI −0.67 to −0.32; p < 0.001). No significant differences were observed in SMD of serum albumin concentrations between COPD patients with forced expiratory volume in the 1st second (FEV1) < 50% and those with FEV1 > 50%. Conclusions: Our systematic review and meta-analysis showed that serum albumin concentrations are significantly lower in patients with stable COPD compared to non-COPD controls. This supports the presence of a deficit in systemic anti-inflammatory and antioxidant defense mechanisms in COPD.

scholarly journals Combination of Jinshuibao Capsules and Conventional Pharmaceutical Treatments for Patients with Stable Chronic Obstructive Pulmonary Disease: A Systematic Review and a Meta-Analysis

2021 ◽  
Author(s):  
Yilan Wang ◽  
◽  
Sijing Zhao ◽  
Zherui Shen ◽  
Zhenxing Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Chronic Obstructive ◽  
Clinical Trial Registry ◽  
Service Platform ◽  
Obstructive Pulmonary Disease ◽  
Integration Service

Review question / Objective: Jinshuibao capsules are derived from Cordyceps, and they have been widely used in the treatment of different diseases. They have also been utilized in the treatment of respiratory diseases, while their effects on patients with stable chronic obstructive pulmonary disease (COPD) have remained elusive. The present study aimed to compare the efficacy of Jinshuibao capsules plus conventional pharmaceutical treatments (CPT) versus CPT alone for patients with stable COPD. Information sources: It was attempted to conduct a systematic review and a meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. In addition, PubMed, EMBASE, Cochrane Library, Web of Science, China Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, VIP Information Resource Integration Service Platform (CQVIP), and China Biomedicine (SinoMed) databases were searched from inception until September 30, 2021. Google Scholar and the China Clinical Trial Registry were also searched for retrieving missing data. In emergency conditions, we contacted the corresponding authors of retrieved studies for collection of additional data.

scholarly journals Association between serum adiponectin concentrations and chronic obstructive pulmonary disease: a meta-analysis

2020 ◽  
Vol 40 (3) ◽  
Author(s):  
Yi-Hua Lin ◽  
Tian-Xiang Jiang ◽  
Su-Xian Hu ◽  
Yong-Hong Shi
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Meta Analysis ◽  
Serum Adiponectin ◽  
Cochrane Library ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Mean Differences ◽  
Serum Adiponectin Concentration

Abstract Background: Adiponectin has been implicated to play a role in the pathophysiology of chronic obstructive pulmonary disease (COPD). Many studies have assessed serum adiponectin concentrations in COPD patients. However, results from different reports were not consistent. To assess the association of serum adiponectin concentrations and COPD, a meta-analysis was performed. Methods: PubMed, Embase, Web of Science and Cochrane Library were searched for eligible studies. Data were extracted, and then standard mean differences (SMDs) and 95% confidence intervals (CI) were calculated. Results: Thirteen studies involving a total of 1131 cases and 689 controls were included in this meta-analysis. Combined data indicated that the serum adiponectin levels were higher in COPD patients than those in controls (SMD: 1.09, 95% CI [0.73–1.45], P &lt; 0.001). In the subgroup analyses by disease period, there were similar results in stable COPD patients (SMD: 0.77, 95% CI [0.47–1.07], p &lt;0.001; I2 = 83.9%, P &lt; 0.001), AECOPD patients (SMD: 2.51, 95% CI [0.71–4.30], P = 0.006; I2 = 95.2%, P &lt; 0.001) and mixed COPD patients (SMD: 1.21, 95% CI [0.67–1.75], P &lt; 0.001). Furthermore, the serum adiponectin levels were higher in AECOPD patients than those in stable COPD patients (SMD: 1.06, 95% CI [0.13–1.99], P = 0.026). Conclusions: This meta-analysis indicates that patients with COPD have higher serum adiponectin concentration than healthy controls.

Impact of chronic obstructive pulmonary disease on mortality in community acquired pneumonia: a meta-analysis

2020 ◽  
Vol 9 (12) ◽  
pp. 839-848
Author(s):  
Hui Ma ◽  
Ting Liu ◽  
Yongxiang Zhang ◽  
Zhen Ye ◽  
Wei Jia ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Meta Analysis ◽  
Positive Association ◽  
Community Acquired Pneumonia ◽  
Cochrane Library ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Short And Long Term ◽  
The Impact

Background: The aim of the present study was to systematically review the exiting literature and to proceed a meta-analysis to determine the impact of chronic obstructive pulmonary disease (COPD) on mortality in patients with community acquired pneumonia. Materials & methods: Eligible studies were searched from PubMed, Cochrane Library and EMBASE. Odds ratios (ORs) with 95% CIs were used as effect estimates. Results: Twenty cohort studies were included. Analysis of unadjusted data revealed nonsignificant short- and long-term mortality associated with COPD. Analysis of adjusted 30-days mortality showed similarly no association between COPD and increased 30-days mortality (OR: 1.06, [0.68, 1.44]) but a positive association when COPD was confirmed spirometrically (OR: 1.84, [1.06, 2.62]). Conclusion: There is still no evidence to clear the impact of COPD on mortality in patients with community acquired pneumonia. More prospective studies with spirometrically-defined COPD and adequate adjustment for confounders are needed.

Objectively Measured Steps/Day in Patients With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 13 (11) ◽  
pp. 1275-1283 ◽  
Author(s):  
Travis Saunders ◽  
Nerissa Campbell ◽  
Timothy Jason ◽  
Gail Dechman ◽  
Paul Hernandez ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Meta Analysis ◽  
Airflow Obstruction ◽  
Forced Expiratory Volume ◽  
Activity Level ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Objectively Measured

Background:Although individual studies have reported on the number of steps/day taken by individuals with chronic obstructive pulmonary disease (COPD), this evidence has not been systematically reviewed or synthesized.Methods:MEDLINE and PsycINFO were searched for studies reporting objectively-measured steps/day and percent predicted forced expiratory volume in 1 second (FEV1%) in patients with COPD. Meta-analyses were used to estimate steps/day across studies, while metaregression was used to estimate between-study variance based on clinical and demographic factors (year and location of study, activity monitor brand, number of days wearing the monitor, whether participants were about to enter pulmonary rehabilitation, 6-minute walk distance (6MWD), FEV1%, age, and sex).Results:38 studies including 2621 participants met inclusion criteria. The pooled mean estimate was 4579 steps/day (95% CI:4310 to 5208) for individuals with COPD. Only 6MWD, FEV1% and whether patients were about to undergo pulmonary rehabilitation explained a significant portion of the variance (P < 0.1) in univariate meta-regression. In a multivariate model including the above risk factors, only FEV1% was associated with steps/day after adjustment for other covariates.Conclusions:These results indicate that patients with COPD achieve extremely low levels of physical activity as assessed by steps/day, and that severity of airflow obstruction is associated with activity level.

scholarly journals Protocol for a systematic literature review and network meta-analysis of the clinical benefit of inhaled maintenance therapies in chronic obstructive pulmonary disease

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e025048 ◽  
Author(s):  
Adam Lewis ◽  
Eleanor L Axson ◽  
James Potts ◽  
Renelle Tarnowska ◽  
Helene Vioix ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Cochrane Library ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
Inhaled Therapy

IntroductionChronic obstructive pulmonary disease (COPD) exacerbations progress the course of disease and impair lung function. Inhaled maintenance therapy reduces exacerbations. It is not yet established which inhaled therapy combination is best to reduce exacerbations, lung function decline and symptom burden.Methods and analysisMEDLINE, EMBASE and the Cochrane Library will be searched for articles between January 2011 and May 2018 using a pre-specified search strategy. Conference proceedings will be searched. Systematic reviews (with or without meta-analysis), randomised controlled trials (RCTs), cohort studies and case controlled studies comparing six interventions comprising different combinations of long-acting bronchodilators and inhaled corticosteroids in unison or on their own. The primary outcome is the reduction in moderate-to-severe exacerbations. Secondary outcomes include: lung function, quality of life, mortality and other adverse events. Titles and abstracts will screened by the primary researcher. A second reviewer will repeat this on a proportion of records. The Population, Intervention, Comparator, Outcomes and Study framework will be used for data extraction. A network meta-analyses of outcomes from RCTs and real-world evidence will be integrated if feasible. The 95% credible interval will be used to assess the statistical significance of each summary effect. Ranking of interventions will be based on their surface under cumulative ranking area.Ethics and disseminationCOPD exacerbations are burdensome to patients. We aim to report results that provide clinicians with a more informed choice of which inhaled therapy combinations are best to reduce exacerbations, improve disease burden and reduce lung function and exercise capacity decline, compared with the potential harms, in certain populations with COPD.PROSPERO registration numberCRD42018088013.

scholarly journals Endothelial dysfunction in chronic obstructive pulmonary disease: a systematic review and meta-analysis of studies using different functional assessment methods

2021 ◽  
pp. 00983-2020
Author(s):  
Marieta P. Theodorakopoulou ◽  
Maria Eleni Alexandrou ◽  
Dimitra Rafailia Bakaloudi ◽  
Georgia Pitsiou ◽  
Ioannis Stanopoulos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Chronic Obstructive Pulmonary Disease ◽  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Pulmonary Disease ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

BackgroundCardiovascular disease is a major cause of morbidity and mortality in chronic obstructive pulmonary disease (COPD). Endothelial dysfunction is suggested to be one of the pathogenetic mechanisms involved. This is a systematic review and meta-analysis of studies using any available functional method to examine differences in endothelial function between patients with COPD and individuals without COPD (controls).MethodsLiterature search involved PubMed and Scopus databases. Eligible studies included adult patients and evaluated endothelial damage via functional methods. Newcastle-Ottawa Scale was applied to evaluate the quality of retrieved studies. Subgroup analyses were performed to explore heterogeneity across the studies. Funnel-plots were constructed to evaluate publication bias.ResultsOf the 21 initially identified reports, 19 studies with a total of 968 participants were included in the final meta-analysis. A significantly impaired response in endothelium-dependent (weighted mean between-group difference, WMD: −2.59%, 95%CI [−3.75, −1.42]) and –independent vasodilation (WMD: −3.13, 95%CI [−5.18, −1.09]) was observed in patients with COPD compared to controls. When pooling all studies together, regardless of the technique used for assessment of vascular reactivity, pronounced endothelial dysfunction was observed in COPD compared to controls (standardised-mean-difference, SMD: −1.19, 95%CI [−1.69, −0.68]). Subgroup analysis showed that the difference was larger when patients with COPD were compared with non-smoking controls (SMD: −1.75, 95%CI [−2.58, −0.92]. Sensitivity analyses confirmed the above results.ConclusionsPatients with COPD have significantly impaired endothelial function compared to controls without COPD. Future studies should delineate the importance of endothelial dysfunction towards development of cardiovascular disease in COPD.

scholarly journals The characteristics of the frequent exacerbator with chronic bronchitis phenotype and non-exacerbator phenotype in patients with chronic obstructive pulmonary disease: a meta-analysis and system review

2020 ◽  
Author(s):  
Jianjun Wu ◽  
Hong-ri Xu ◽  
Ying-xue Zhang ◽  
Yi-xuan Li ◽  
Hui-yong Yu ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Bronchitis ◽  
Pulmonary Disease ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Meta Analysis ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Abstract Objective: To investigate the clinical characteristics between the frequent exacerbator with chronic bronchitis (FE-CB) phenotype and the non-exacerbator (NE) phenotype among patients with chronic obstructive pulmonary disease (COPD). Methods: We searched CNKI, Wan fang, Chongqing VIP, China Biology Medicine disc, PubMed, Cochrane Library, and EMBASE databases for relevant studies published as of April 30, 2019. All studies that investigated COPD patients with the FE-CB and NE phenotypes and which qualified the inclusion criteria were included. Cross-Sectional/Prevalence Study Quality recommendations were used to measure methodological quality. RevMan5.3 software was used for meta-analysis. Results: Ten case-control studies (n=8848) were included. Compared with the NE phenotype, patients with the FE-CB phenotype showed significantly lower forced vital capacity percent predicted (FVC%pred) [mean difference (MD) -6.69, 95% confidence interval (CI) -7.73–-5.65, P<0.001, I2=5%], forced expiratory volume in one second percent predicted (FEV1%pred) (MD -8.50, 95% CI -11.36–-5.65, P<0.001, I2=91%), and forced expiratory volume in one second/forced vital capacity (FEV1/FVC) (MD -3.76, 95% CI -4.58–-2.95,P<0.001, I2=0%); in contrast, the quantity of cigarettes smoked (pack-years) (MD 3.09, 95% CI 1.60–4.58, P<0.001, I2=41%), COPD assessment test (CAT) score (MD 5.61, 95% CI 4.62–6.60, P<0.001, I2=80%), modified Medical British Research Council (mMRC) score (MD 0.72, 95% CI 0.63–0.82, P<0.001, I2=57%), exacerbations in previous year (2.65, 95% CI 2.32–2.97, P<0.001, I2=91%), body mass index (BMI), obstruction, dyspnea, exacerbations (BODEx) (MD 1.78, 95% CI 1.28–2.28, P<0.001, I2=91%), I2=34%), and Charlson comorbidity index (MD 0.47, 95% CI 0.37–0.58, P<0.001, I2=0] were significantly higher in patients with FE-CB phenotype. No significant between-group difference was observed with respect to BMI (MD-0.14, 95% CI -0.70–0.42, P=0.62, I2=75%). Conclusion: COPD patients with the FE-CB phenotype had poorer pulmonary function and higher CAT score, the quantity of cigarettes smoked (pack-years), frequency of acute exacerbations, and mMRC scores than those with the NE phenotype.

scholarly journals Association between Chronic Obstructive Pulmonary Disease and Dementia: Systematic Review and Meta-Analysis of Cohort Studies

2019 ◽  
Vol 9 (2) ◽  
pp. 250-259 ◽  
Author(s):  
Ying Wang ◽  
Xiaotong Li ◽  
Biying Wei ◽  
Tao-Hsin Tung ◽  
Ping Tao ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cohort Studies ◽  
Pulmonary Disease ◽  
Meta Analysis ◽  
The Elderly ◽  
Cochrane Library ◽  
Chronic Obstructive ◽  
Common Disease ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Background: Chronic obstructive pulmonary disease (COPD) is a common disease among the elderly, which has been linked to cognitive decline. However, the relationship between COPD and dementia remains unclear. Summary: We conducted a systematic literature review by searching databases such as Pubmed, Embase, EBSCO, and Cochrane Library (from inception to April 18, 2018) for studies on COPD that also investigated the prevalence of dementia. We found 3 cohort studies including a total of 39,392 COPD patients. Then we applied the Newcastle-Ottawa Scale to evaluate the risk of bias. Key Messages: COPD patients faced a higher risk of dementia (HR 1.46; 95% CI 1.22–1.75; p < 0.001). Subgroup analysis on gender determined that the association between COPD and dementia was stronger in male patients (HR 1.49, 95% CI 1.20–1.86, p < 0.001) than in female patients (HR 1.41, 95% CI 1.27–1.57, p < 0.001). A subset study of patients aged >65 years revealed that the HR was greater for patients aged ≥75 years (HR 1.46, 95% CI 1.07–2.00, p = 0.02) than for those aged 65–74 years (HR 1.40, 95% CI 1.28–1.53, p < 0.001). The cohort studies included were from similar population-based databases, suggesting possible regional limitations and publication bias.

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