scholarly journals A Systematic Review of the Association Between Vegan Diets and Risk of Cardiovascular Disease

2021 ◽  
Author(s):  
Jeenan Kaiser ◽  
Kim R van Daalen ◽  
Arjun Thayyil ◽  
Mafalda Tasso de Almeida Ribeiro Reis Cocco ◽  
Daniela Caputo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Ischemic Stroke ◽  
Intima Media Thickness ◽  
Protective Role ◽  
Environmental Benefits ◽  
Vegan Diet ◽  
High Quality Research ◽  
Animal Products ◽  
Evaluation Approach

ABSTRACT Background Plant-based diets are gaining attention globally due to their environmental benefits and perceived health-protective role. A vegan diet may have cardiovascular benefits; however, evidence remains conflicting and insufficiently assessed. Objectives We evaluated the utility of the vegan diet in cardiovascular disease (CVD) prevention. Methods We conducted a systematic review of studies evaluating the association between vegan diets and cardiovascular outcomes. We searched 5 databases (Ovid MEDLINE, EMBASE, Web of Science, Scopus, and OpenGrey) through 31 October 2020. Four investigators independently screened the full texts for inclusion, assessed quality, and extracted data from published reports. Results Out of the 5729 identified records, 7 were included, comprising over 73,000 participants, of whom at least 7661 were vegans. Three studies, with at least 73,426 individuals (including at least 7380 vegans), examined risks of primary cardiovascular events (total CVD, coronary heart disease, acute myocardial infarction, total stroke, hemorrhagic stroke, and ischemic stroke) in individuals who followed a vegan diet compared to those who did not. None of the studies reported a significantly increased or decreased risk of any cardiovascular outcome. One study suggested that vegans were at greater risk of ischemic stroke compared to individuals who consumed animal products (HR, 1.54; 95% CI, 0.95–2.48). Yet in another study, vegans showed lower common carotid artery intima-media thickness (0.56 ± 0.1 mm vs. 0.74 ± 0.1 mm in controls; P < 0.001), and in 3 studies of recurrent CVD events, vegans had 0–52% lower rates. Furthermore, endothelial function did not differ between vegans and nonvegans. Using the Grading of Recommendations Assessment, Development and Evaluation approach, evidence was deemed to be of low to very low strength/quality. Conclusions Among the Western populations studied, evidence weakly demonstrates associations between vegan diets and risk of CVDs, with the direction of associations varying with the specific CVD outcome tested. However, more high-quality research on this topic is needed. This study was registered at PROSPERO as CRD42019146835.

scholarly journals Elevated Blood Pressure in Childhood or Adolescence and Cardiovascular Outcomes in Adulthood

Hypertension ◽  
2020 ◽  
Vol 75 (4) ◽  
pp. 948-955 ◽  
Author(s):  
Lili Yang ◽  
Costan G. Magnussen ◽  
Liu Yang ◽  
Pascal Bovet ◽  
Bo Xi
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Ventricular Hypertrophy ◽  
Pulse Wave ◽  
Meta Analysis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Left Ventricular ◽  
Cardiovascular Morbidity And Mortality ◽  
High Pulse

There remains some uncertainty about the magnitude of the associations between elevated blood pressure (BP) in childhood or adolescence and cardiovascular morbidity and mortality in adulthood. We summarized evidence on the long-term impact of elevated BP in childhood or adolescence on cardiovascular morbidity and mortality in adulthood. PubMed and Embase databases were searched up to August 1, 2019, and retrieved studies were reviewed manually. Our systematic review included all eligible prospective cohort studies on the associations between BP status in childhood or adolescence and intermediate markers or hard outcomes of cardiovascular disease in adults, including high pulse wave velocity, high carotid intima-media thickness, left ventricular hypertrophy, and cardiovascular disease (fatal and nonfatal) and total mortality. A total of 19 articles were finally included, and 12 could be synthesized by meta-analysis. Elevated BP in childhood or adolescence was significantly associated, in adulthood, with high pulse wave velocity (3 articles, N=3725; pooled odds ratio [OR], 1.83 [95% CI, 1.39–2.40]); high carotid intima-media thickness (2 articles, N=4152; OR, 1.60 [95% CI, 1.29–2.00]); and left ventricular hypertrophy (2 articles, N=3019; OR, 1.40 [95% CI, 1.20–1.64]). Additionally, our systematic review also shows evidence of associations of elevated BP in youth with cardiovascular disease and mortality in adulthood. In conclusion, our systematic review and meta-analysis confirms that elevated BP in childhood or adolescence is associated with several intermediate markers and hard outcomes of cardiovascular disease in adulthood. These findings emphasize the importance for children and adolescents to have their BP within normal values.

Mechanical thrombectomy in pediatric stroke: systematic review, individual patient data meta-analysis, and case series

2019 ◽  
Vol 24 (5) ◽  
pp. 558-571 ◽  
Author(s):  
Kartik Bhatia ◽  
Hans Kortman ◽  
Christopher Blair ◽  
Geoffrey Parker ◽  
David Brunacci ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Neurological Outcomes

OBJECTIVEThe role of mechanical thrombectomy in pediatric acute ischemic stroke is uncertain, despite extensive evidence of benefit in adults. The existing literature consists of several recent small single-arm cohort studies, as well as multiple prior small case series and case reports. Published reports of pediatric cases have increased markedly since 2015, after the publication of the positive trials in adults. The recent AHA/ASA Scientific Statement on this issue was informed predominantly by pre-2015 case reports and identified several knowledge gaps, including how young a child may undergo thrombectomy. A repeat systematic review and meta-analysis is warranted to help guide therapeutic decisions and address gaps in knowledge.METHODSUsing PRISMA-IPD guidelines, the authors performed a systematic review of the literature from 1999 to April 2019 and individual patient data meta-analysis, with 2 independent reviewers. An additional series of 3 cases in adolescent males from one of the authors’ centers was also included. The primary outcomes were the rate of good long-term (mRS score 0–2 at final follow-up) and short-term (reduction in NIHSS score by ≥ 8 points or NIHSS score 0–1 at up to 24 hours post-thrombectomy) neurological outcomes following mechanical thrombectomy for acute ischemic stroke in patients < 18 years of age. The secondary outcome was the rate of successful angiographic recanalization (mTICI score 2b/3).RESULTSThe authors’ review yielded 113 cases of mechanical thrombectomy in 110 pediatric patients. Although complete follow-up data are not available for all patients, 87 of 96 (90.6%) had good long-term neurological outcomes (mRS score 0–2), 55 of 79 (69.6%) had good short-term neurological outcomes, and 86 of 98 (87.8%) had successful angiographic recanalization (mTICI score 2b/3). Death occurred in 2 patients and symptomatic intracranial hemorrhage in 1 patient. Sixteen published thrombectomy cases were identified in children < 5 years of age.CONCLUSIONSMechanical thrombectomy may be considered for acute ischemic stroke due to large vessel occlusion (ICA terminus, M1, basilar artery) in patients aged 1–18 years (Level C evidence; Class IIb recommendation). The existing evidence base is likely affected by selection and publication bias. A prospective multinational registry is recommended as the next investigative step.

Thrombolytic Therapy in the Current ERA: Myocardial Infarction and Beyond

2018 ◽  
Vol 24 (4) ◽  
pp. 414-426 ◽  
Author(s):  
Patrick Proctor ◽  
Massoud A. Leesar ◽  
Arka Chatterjee
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Coronary Intervention ◽  
Evidence Base ◽  
Primary Pci ◽  
Percutaneous Coronary

Thrombolytic therapy kick-started the era of modern cardiology but in the last few decades it has been largely supplanted by primary percutaneous coronary intervention (PCI) as the go-to treatment for acute myocardial infarction. However, these agents remain important for vast populations without access to primary PCI and acute ischemic stroke. More innovative uses have recently come up for the treatment of a variety of conditions. This article summarizes the history, evidence base and current use of thrombolytics in cardiovascular disease.

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