Subclinical atherosclerosis is associated with incident atrial fibrillation: a systematic review and meta-analysis

Abstract Aims Coronary artery disease is an established risk factor for incident atrial fibrillation (AF), but it is unclear whether subclinical atherosclerosis also increases the risk of incident AF. Therefore, the aim was to assess the association between subclinical atherosclerosis, defined by increased carotid intima-media thickness (cIMT) or coronary artery calcium score (CACS), and incident AF. Methods and results A systematic review of MEDLINE, EMBASE, and Cochrane was done to find all cohort studies investigating the association between subclinical atherosclerosis, defined by increased cIMT or CACS, and incident AF. Eligible articles had to be available in an English full-text version; include adults over the age of 18 years; include ≥100 participants; and have a follow-up period ≥12 months. Data on cIMT were pooled using a fixed-effects model, while data on CACS (I2 >25) were pooled using a random-effects model. Five studies on cIMT including 36 333 patients and two studies on CACS including 34 603 patients were identified. All studies investigating the association between increased cIMT and incident AF showed a significant association, with an overall hazard ratio (HR) of 1.43 [95% confidence interval (CI) 1.27–1.59]. The two studies investigating the association between increased CACS and AF also showed a significant association with an overall HR of 1.07 (95% CI 1.02–1.12). Conclusion Data from seven observational studies suggest that subclinical atherosclerosis defined by increased cIMT or CACS is associated with an increased risk of incident AF. These findings emphasize the need for further research investigating whether treatment of subclinical atherosclerosis should be a part of the initiatives to prevent AF.

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Abstract 14648: Gender Differences in Procedural Complications Associated With Atrial Fibrillation Catheter Ablation: A Systematic Review and Meta-analysis of 244,353 Patients

Circulation ◽

10.1161/circ.142.suppl_3.14648 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Martin L Campbell ◽

John Larson ◽

Talha Farid ◽

Stacy Westerman ◽

Michael S Lloyd ◽

...

Keyword(s):

Atrial Fibrillation ◽

Systematic Review ◽

Catheter Ablation ◽

Gender Gap ◽

Major Bleeding ◽

Fixed Effects ◽

Meta Analysis ◽

Vascular Complications ◽

Increased Risk ◽

Procedural Complications

Introduction: Women undergoing atrial fibrillation catheter ablation (AFCA) have higher rates of vascular complications and major bleeding. However, studies have been underpowered to detect differences in rare complications such as stroke/transient ischemic attack (TIA) and procedural mortality. Methods: We performed a systematic review of databases (PubMed, World of Science, Embase) to identify studies published since 2010 reporting AFCA complications by gender. Six complications of interest were: 1) vascular/groin complications; 2) pericardial effusion/tamponade; 3) stroke/TIA; 4) permanent phrenic nerve injury; 5) major bleeding & 6) procedural mortality. For meta-analysis, random effects models were used when heterogeneity between studies was ≥ 50% (vascular complications, major bleeding) and fixed effects models for other endpoints. Results: Of 5716 citations, 19 studies met inclusion criteria, comprising 244,353 patients undergoing AFCA, of whom 33% were women. Women were older (65.3 ± 11.2 vs. 60.4 ± 13.2 years), more likely hypertensive (60.6 vs. 55.5%) and diabetic (18.3 vs. 16.5%) and had higher CHA 2 DS 2 -VASc scores (3.0 ± 1.8 vs. 1.4 ± 1.4) (p<0.0001 for all comparisons). The rates of all 6 complications were significantly higher in women (Table). However, despite statistically significant differences, the overall incidences of major complications were very low in both genders: stroke/TIA (women 0.51 vs. men 0.39%) and procedural mortality (women 0.25 vs. men 0.18%). Conclusion: Women experience significantly higher rates of AFCA complications. However, the incidence of major procedural complications is very low in both genders. The higher rate of complications in women may be partially attributable to older age and a higher prevalence of comorbidities at the time of ablation. More detailed studies are needed to better define the mechanisms of increased risk in women and to identify strategies for closing the gender gap.

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Incidence and risk of neutropenia with palbociclib in patients with cancer: A systematic review and meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e12530 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e12530-e12530

Author(s):

Yan Mao ◽

Janice Lu ◽

Haibo Wang ◽

Gang Nie

Keyword(s):

Systematic Review ◽

Fixed Effects ◽

Meta Analysis ◽

Significant Risk ◽

Metastatic Breast ◽

Progression Free Survival ◽

High Grade ◽

Fixed Effects Model ◽

Patients With Cancer ◽

Increased Risk

e12530 Background: Palbociclib is an oral small-molecule inhibitor of cyclin-dependent kinases 4 and 6 and has improved the progression-free survival of estrogen receptor positive, metastatic breast cancer (MBC). Its application in other cancers is also undergoing clinical evaluation. Neutropenia, especially high grade (grade 3 or 4), is one of the major side-effects of palbociclib, and the incidence was reported too vary in different studies. In order to better understand the overall risk of palbociclib associated neutropenia, we conducted a systematic review and meta-analysis. Methods: We conducted a systematic literature search (including Medline, Web of Science to November, 2016 and abstracts presented at the ASCO annual meetings from 2009 to 2016). Eligible studies include prospective clinical trials of patients with cancer treated with palbociclib on a 125mg daily 3/4 week schedule and have available data on neutropenia. The incidence and relative risk (RR) of neutropenia were calculated using a random-effects or fixed-effects model, depending on the heterogeneity of the included studies. Results: Eight studies published between 2012 and 2016 included a total of 1515 patients with cancer were eligible for analysis. For patients treated with palbociclib, the overall incidence of all-grade and high grade neutropenia were 77.4% (95% CI 70.9-82.8%) and 60.9% (57.8–63.8%), respectively. Surprisingly, the incidence of neutropenia was significantly different between MBC patients and non-MBC patients (all grade: RR 1.26 [95% CI 1.01–1.56], p = 0.041; high-grade: RR 1.57 [1.23–2.00], p = 0.000) who received palbociclib. Palbociclib was associated with a significantly increased risk of all-grade neutropenia in patients with cancer with an RR of 15.03 (10.17–22.21, p < 0.001) compared with controls. Conclusions: Patients with cancer who received palbociclib have a significant risk of developing neutropenia, especially MBC patients. It is strongly recommended to monitor these patients who are treated with palbociclib to adjust dose, treatment intervals, and avoid infections.

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An increased risk of lung cancer in combined pulmonary fibrosis and emphysema patients with usual interstitial pneumonia compared with patients with idiopathic pulmonary fibrosis alone: a systematic review and meta-analysis

Therapeutic Advances in Respiratory Disease ◽

10.1177/17534666211017050 ◽

2021 ◽

Vol 15 ◽

pp. 175346662110170

Author(s):

Qianqian Chen ◽

Ping Liu ◽

Hong Zhou ◽

Hui Kong ◽

Weiping Xie

Keyword(s):

Lung Cancer ◽

Systematic Review ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Interstitial Pneumonia ◽

Fixed Effects ◽

Meta Analysis ◽

Usual Interstitial Pneumonia ◽

Fixed Effects Model ◽

Increased Risk

Background: Lung cancer is an important complication of combined pulmonary fibrosis and emphysema (CPFE). Whether the risk of lung cancer is higher in CPFE patients with usual interstitial pneumonia (UIP) than those with idiopathic pulmonary fibrosis (IPF) alone, remains controversial. We conducted this systematic review and meta-analysis to evaluate the prevalence of lung cancer in CPFE patients with UIP compared with IPF patients. Methods: We searched the PubMed, Embase, and Cochrane databases for studies that focused on the incidence of lung cancer in CPFE/UIP and IPF groups. We used a fixed-effects model to analyze the odds ratios (ORs) with 95% confidence intervals (CIs) according to data heterogeneity. The cumulative effects based on the publication year and sample size were assessed by cumulative meta-analysis. Results: A total of nine studies with 933 patients, including 374 CPFE patients with UIP, fulfilled the inclusion criteria. Overall, CPFE patients with UIP have a higher risk of lung cancer than those with IPF alone (OR = 2.69; 95% CI: 1.78–4.05). There were increased risks of lung cancer in CPFE/UIP patients with the presence of emphysema (OR = 2.93; 95% CI: 1.79–4.79) or emphysema in ⩾10% of the lung volume (OR = 2.22; 95% CI: 1.06–4.68). Conclusions: Our systematic review and meta-analysis indicated a significantly higher prevalence of lung cancer in CPFE patients with UIP than in patients with IPF alone. The reviews of this paper are available via the supplemental material section.

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P2Y12 inhibitors with oral anticoagulation for percutaneous coronary intervention with atrial fibrillation: a systematic review and meta-analysis

Heart ◽

10.1136/heartjnl-2019-315963 ◽

2020 ◽

Vol 106 (8) ◽

pp. 575-583 ◽

Cited By ~ 5

Author(s):

Florentino Lupercio ◽

Shaun Giancaterino ◽

Pedro Arturo Villablanca ◽

Frederick Han ◽

Kurt Hoffmayer ◽

...

Keyword(s):

Atrial Fibrillation ◽

Systematic Review ◽

Percutaneous Coronary Intervention ◽

Oral Anticoagulation ◽

Fixed Effects ◽

Meta Analysis ◽

Coronary Intervention ◽

Fixed Effects Model ◽

Cardiac Events ◽

Percutaneous Coronary

ObjectiveThis study aimed to compare the safety and efficacy of third-generation P2Y12 inhibitors versus clopidogrel in combination with oral anticoagulation (OAC) with or without aspirin in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI).MethodsWe performed a systematic review including both prospective and retrospective studies that compared dual and triple antithrombotic regimens for bleeding and major adverse cardiac events (MACE) in patients with AF undergoing PCI. We analysed rates of bleeding and MACE by P2Y12 inhibitor choice. Risk ratio (RR) 95% CIs were measured using the Mantel-Haenszel method. Where study heterogeneity was low (I2 <25%), we used the fixed effects model, otherwise the random effects model was used.ResultsA total of 22 014 patients were analysed from the seven studies included. Among patients treated with both OAC and P2Y12 inhibitor with or without aspirin, 90% (n=9708) were treated with clopidogrel, 8% (n=830) with ticagrelor, and 2% (n=191) with prasugrel. When compared with clopidogrel, use of ticagrelor (RR 1.36; 95% CI 1.18 to 1.57) and prasugrel (RR 2.11; 95% CI 1.34 to 3.30) were associated with increased rates of bleeding. Compared with clopidogrel, there were no significant differences in rates of MACE with ticagrelor (RR 1.03; 95% CI 0.65 to 1.62) or prasugrel (RR 1.49; 95% CI 0.69 to 3.24).ConclusionBased on this meta-analysis, the use of clopidogrel is associated with a lower rate of bleeding compared with ticagrelor or prasugrel in patients with AF on OAC undergoing PCI.

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Pruritus in patients treated with targeted cancer therapies: Systematic review and meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e13571 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e13571-e13571

Author(s):

Courtney J. Ensslin ◽

Alyx C. Rosen ◽

Shenhong Wu ◽

Mario E. Lacouture

Keyword(s):

Systematic Review ◽

Targeted Therapies ◽

Fixed Effects ◽

Meta Analysis ◽

Significant Risk ◽

Cancer Therapies ◽

Fixed Effects Model ◽

Increased Risk ◽

Targeted Cancer Therapies ◽

American Society

e13571 Background: Pruritus is a disabling symptom that has been anecdotally described in patients treated with targeted cancer therapies, and reports on its incidence vary. The overall risk to develop pruritus in these patients has not been systematically ascertained. We conducted a systematic review and meta-analysis of the literature to determine the incidence and risk of developing pruritus among patients treated with targeted therapies. Methods: Databases from PubMed and Web of Science from January 1998 until July 2012 and abstracts presented at the American Society of Clinical Oncology annual meetings from 2004 through 2012 were searched to identify relevant studies. The incidence and relative risk (RR) of pruritus were calculated using random-effects or fixed-effects model depending on the heterogeneity of included studies. Results: Of 5,065 studies initially identified, a total of 20,532 patients from 144 studies were included for analysis. The summary incidences of all-grade and high-grade pruritus were 17.4% (95% confidence interval (CI): 16.0%-19.0%) and 1.4% (95% CI: 1.2%-1.6%). From randomized controlled trials, patients treated with targeted therapies had a significantly increased risk of developing all-grade pruritus, with an overall RR of 2.59 (95% CI: 2.03-3.30, p<0.001); there was a significant variation among different classes of drugs (P<0.001). Conclusions: There is a significant risk of developing pruritus in cancer patients receiving targeted therapies. In order to prevent suboptimal dosing and reductions in quality of life, these patients should be counseled and treated against this disabling event.

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Maternal Infection During Pregnancy and Risk of Cerebral Palsy in Children: A Systematic Review and Meta-analysis

Journal of Child Neurology ◽

10.1177/0883073820972507 ◽

2020 ◽

pp. 088307382097250

Author(s):

Erfan Ayubi ◽

Saeedeh Sarhadi ◽

Kamyar Mansori

Keyword(s):

Systematic Review ◽

Cerebral Palsy ◽

Publication Bias ◽

Fixed Effects ◽

Meta Analysis ◽

Fixed Effects Model ◽

Maternal Infection ◽

Relative Risks ◽

Increased Risk ◽

Newcastle Ottawa Scale

Background and aim: The association between maternal infection during pregnancy and the risk of cerebral palsy has been previously reported. However, their results were relatively inconsistent. This systematic review and meta-analysis were carried out to investigate the association between maternal infection during pregnancy and the risk of cerebral palsy in children. Methods: PubMed, Scopus, and Web of Sciences databases were searched from inception to October 28, 2019. Heterogeneity was assessed using the I2 value. In case of substantial heterogeneity (I2 > 50%), a random effects model was applied, otherwise, a fixed effects model was used. The pooled associations were expressed as relative risks (RRs) and 95% confidence intervals (CIs). Publication bias and quality of studies included in the systematic review were checked using the Egger’s regression test and Newcastle-Ottawa Scale (NOS), respectively. Results: Thirty-seven studies were included in the systematic review. Among them, 21 studies were eligible for the meta-analysis. The pooled RR of cerebral palsy risk was 2.50 (95% CI 1.94, 3.21; I2 = 88.7%, P < .001) among children born to mothers who had any infection during pregnancy. The risk was increased to 2.85 (95% CI 1.96, 4.15; I2 = 75.9%, P < .001) when the mother was diagnosed with chorioamnionitis. Publication bias tests suggested no evidence of potential publication bias and 76% of the studies included in the meta-analysis were of high quality (NOS ≥ 6). Conclusion: This systematic review and meta-analysis provides evidence that maternal infection during pregnancy may be associated with an increased risk of cerebral palsy in children.

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Predictive Value of Hypoalbuminemia for Contrast-Associated Acute Kidney Injury: A Systematic Review and Meta-Analysis

Angiology ◽

10.1177/0003319721989185 ◽

2021 ◽

pp. 000331972198918

Author(s):

Liwei Liu ◽

Zhubin Lun ◽

Bo Wang ◽

Li Lei ◽

Guoli Sun ◽

...

Keyword(s):

Systematic Review ◽

Acute Kidney Injury ◽

Predictive Value ◽

Fixed Effects ◽

Meta Analysis ◽

Kidney Injury ◽

Clinical Intervention ◽

Cochrane Library ◽

Fixed Effects Model ◽

Increased Risk

Contrast-associated acute kidney injury (CA-AKI) is a major adverse complication of intravascular administration of contrast medium. Current studies have shown that hypoalbuminemia might be a novel risk factor of CA-AKI. This systematic review and meta-analysis was performed to evaluate the predictive value of hypoalbuminemia for CA-AKI. Relevant studies were identified in Ovid-Medline, PubMed, Embase, and Cochrane Library up to December 31, 2019. Two authors independently screened studies, consulting with a third author when necessary to resolve discrepancies. The pooled odds ratio (OR) was calculated to assess the association between hypoalbuminemia and CA-AKI using a random-effects model or fixed-effects model. Eight relevant studies involving a total of 18 687 patients met our inclusion criteria. The presence of hypoalbuminemia was associated with an increased risk of CA-AKI development (pooled OR: 2.59, 95% CI: 1.80-3.73). Hypoalbuminemia is independently associated with the occurrence of CA-AKI and may be a potentially modifiable factor for clinical intervention. This systematic review and meta-analysis was registered in PROSPERO (CRD42020168104).

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Maternal exposure to sulfonamides and adverse pregnancy outcomes: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0242523 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0242523

Author(s):

Peixuan Li ◽

Xiaoyun Qin ◽

Fangbiao Tao ◽

Kun Huang

Keyword(s):

Systematic Review ◽

Pregnancy Outcomes ◽

Congenital Malformations ◽

Fixed Effects ◽

Meta Analysis ◽

Maternal Exposure ◽

Adverse Pregnancy Outcomes ◽

Fixed Effects Model ◽

Increased Risk ◽

Adverse Pregnancy

Background Sulfonamides are widely used to treat infectious diseases during pregnancy. However, the safety of maternal exposure to sulfonamides is controversial. This study aims to systematically review the available studies and examine the effect of maternal sulfonamides use on adverse pregnancy outcomes. Methods We searched PubMed, Science Direct, Web of Science, ClinicalTrials.gov, CNKI and Wanfang Database (in Chinese). The meta-analysis used random effects model or fixed effects model to obtain the total odds ratio (OR) for each outcome through Stata11.0 software. Study on the relationship between sulfonamide exposure during pregnancy and adverse pregnancy outcomes. The study design covered randomized controlled trials, cohort studies and case-control studies. The study protocol was registered in PROSPERO with protocol number CRD42020178687. Results A total of 10 studies, and 1096350 participants were included for systematic review. Maternal exposure to sulfonamides was found to be possibly associated with increased risk of congenital malformations (OR = 1.21, 95% CI 1.07–1.37). The use of sulfonamides in the first trimester of pregnancy and during the entire pregnancy might be associated with congenital malformations. Conclusions Maternal exposure to sulfonamides may be associated with offspring’ s congenital malformations. Prescription of sulfonamides for pregnant women is suggested to be carefully censored.

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Association between early bronchiolitis and the development of childhood asthma: a meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-043956 ◽

2021 ◽

Vol 11 (5) ◽

pp. e043956

Author(s):

Guizuo Wang ◽

Dong Han ◽

Zhengdong Jiang ◽

Manxiang Li ◽

Shumei Yang ◽

...

Keyword(s):

Early Life ◽

Fixed Effects ◽

Late Onset ◽

Meta Analysis ◽

Later Life ◽

Analysis Data ◽

Fixed Effects Model ◽

Case Control Studies ◽

Increased Risk ◽

Registration Number

ObjectiveEarly life bronchiolitis has been hypothesised to be associated with the subsequent risk of persistent wheezing or asthma. However, the link remains controversial. The objective of our study was to evaluate the association between bronchiolitis before 2 years of age and the late-onset wheezing/asthma.DesignSystematic review and meta-analysis.MethodsPubMed, Embase and Web of Science databases were systematically searched for studies published between 1955 and January 2020. Meanwhile, we also checked through the reference lists of relevant articles to see whether these references included reports of other studies that might be eligible for the review. Cohort and case–control studies assessing the association between early-life bronchiolitis and late-onset wheezing/asthma were included in this meta-analysis. Data were extracted by two independent reviewers. Results were pooled using a random-effects model or fixed-effects model according to the heterogeneity among studies.Results32 original articles with 292 844 participants, which met the criteria, were included in this meta-analysis. Bronchiolitis before 2 years of age was associated with an increased risk of subsequent wheezing/asthma (relative risk=2.46, 95% CI 2.14 to 2.82, p<0.001). After categorising studies into different groups based on age at the end of follow-up, geographical region and study quality, the association still remained significant.ConclusionsThe meta-analysis indicates an association between bronchiolitis before 2 years of age and the wheezing/asthma in later life. Well-designed and highly standardised prospective studies that better address bias due to potential confounding factors are needed to validate the risk identified in our meta-analysis.PROSPERO registration numberCRD42018089453.

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The relationship between migraine and infant colic: A systematic review and meta-analysis

Cephalalgia ◽

10.1177/0333102414534326 ◽

2014 ◽

Vol 35 (1) ◽

pp. 63-72 ◽

Cited By ~ 18

Author(s):

Amy A Gelfand ◽

Peter J Goadsby ◽

I Elaine Allen

Keyword(s):

Systematic Review ◽

Random Effects ◽

Odds Ratio ◽

Fixed Effects ◽

Meta Analysis ◽

Random Effects Model ◽

Fixed Effects Model ◽

Primary Analysis ◽

Infant Colic ◽

The Relationship

Context Infant colic is a common and distressing disorder of early infancy. Its etiology is unknown, making treatment challenging. Several articles have suggested a link to migraine. Objective The objective of this article was to perform a systematic review and, if appropriate, a meta-analysis of the studies on the relationship between infant colic and migraine. Data sources Studies were identified by searching PubMed and ScienceDirect and by hand-searching references and conference proceedings. Study selection For the primary analysis, studies specifically designed to measure the association between colic and migraine were included. For the secondary analysis, studies that collected data on colic and migraine but were designed for another primary research question were also included. Data extraction Data were abstracted from the original studies, through communication with study authors, or both. Two authors independently abstracted data. Main outcomes and measures The main outcome measure was the association between infant colic and migraine using both a fixed-effects model and a more conservative random-effects model. Results Three studies were included in the primary analysis; the odds ratio for the association between migraine and infant colic was 6.5 (4.6–8.9, p < 0.001) for the fixed-effects model and 5.6 (3.3–9.5, p = 0.004) for the random-effects model. In a sensitivity analysis wherein the study with the largest effect size was removed, the odds ratio was 3.6 (95% CI 1.7–7.6, p = 0.001) for both the fixed-effects model and random-effects model. Conclusions In this meta-analysis, infant colic was associated with increased odds of migraine. If infant colic is a migrainous disorder, this would have important implications for treatment. The main limitation of this meta-analysis was the relatively small number of studies included.

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