scholarly journals The association of cardiovascular disease and other pre-existing comorbidities with COVID-19 mortality: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Paddy Ssentongo ◽  
Anna E. Ssentongo ◽  
Emily S. Heilbrunn ◽  
Djibril M Ba ◽  
Vernon M. Chinchilli
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Congestive Heart Failure ◽  
Heart Disease ◽  
Meta Analysis ◽  
High Risk Population ◽  
Risk Of Mortality ◽  
Increased Risk

Background Exploring the association of coronavirus-2019 disease (COVID-19) mortality with chronic pre-existing conditions may promote the importance of targeting these populations during this pandemic to optimize survival. The objective of this systematic review and meta-analysis is to explore the association of pre-existing conditions with COVID-19 mortality. Methods We searched MEDLINE, OVID databases, SCOPUS, and medrxiv.org for the period December 1, 2019, to May 1, 2020. The outcome of interest was the risk of COVID-19 mortality in patients with and without pre-existing conditions. Comorbidities explored were cardiovascular diseases (coronary artery disease, hypertension, cardiac arrhythmias, and congestive heart failure), chronic obstructive pulmonary disease, type 2 diabetes, cancer, chronic kidney disease, chronic liver disease, and stroke. Two independent reviewers extracted data and assessed the risk of bias. All analyses were performed using random-effects models and heterogeneity was quantified. Results Ten chronic conditions from 19 studies were included in the meta-analysis (n = 61,455 patients with COVID-19; mean age, 61 years; 57% male). Overall the between-study study heterogeneity was medium and studies had low publication bias and high quality. Coronary heart disease, hypertension, congestive heart failure, and cancer significantly increased the risk of mortality from COVID-19. The risk of mortality from COVID-19 in patients with coronary heart disease was 2.4 times as high as those without coronary heart disease (RR= 2.40, 95%CI=1.71-3.37, n=5) and twice as high in patients with hypertension as high as that compared to those without hypertension (RR=1.89, 95%CI= 1.58-2.27, n=9). Patients with cancer also were at twice the risk of mortality from COVID-19 compared to those without cancer (RR=1.93 95%CI 1.15-3.24, n=4), and those with congestive heart failure were at 2.5 times the risk of mortality compared to those without congestive heart failure (RR=2.66, 95%CI 1.58-4.48, n=3). Conclusions COVID-19 patients with all any cardiovascular disease, coronary heart disease, hypertension, congestive heart failure, and cancer have an increased risk of mortality. Tailored infection prevention and treatment strategies targeting this high-risk population are warranted to optimize survival.

Abstract P253: Proton Pump Inhibitor Use is Positively Associated with Incidence of Cardiovascular Disease

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Elizabeth J Bell ◽  
Jennifer L St. Sauver ◽  
Veronique L Roger ◽  
Nicholas B Larson ◽  
Hongfang Liu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Language Processing ◽  
Proton Pump ◽  
Hazard Ratio ◽  
Time Varying ◽  
Increased Risk ◽  
The Impact

Introduction: Proton pump inhibitors (PPIs) are used by an estimated 29 million Americans. PPIs increase the levels of asymmetrical dimethylarginine, a known risk factor for cardiovascular disease (CVD). Data from a select population of patients with CVD suggest that PPI use is associated with an increased risk of stroke, heart failure, and coronary heart disease. The impact of PPI use on incident CVD is largely unknown in the general population. Hypothesis: We hypothesized that PPI users have a higher risk of incident total CVD, coronary heart disease, stroke, and heart failure compared to nonusers. To demonstrate specificity of association, we additionally hypothesized that there is not an association between use of H 2 -blockers - another commonly used class of medications with similar indications as PPIs - and CVD. Methods: We used the Rochester Epidemiology Project’s medical records-linkage system to identify all residents of Olmsted County, MN on our baseline date of January 1, 2004 (N=140217). We excluded persons who did not grant permission for their records to be used for research, were <18 years old, had a history of CVD, had missing data for any variable included in our model, or had evidence of PPI use within the previous year.We followed our final cohort (N=58175) for up to 12 years. The administrative censoring date for CVD was 1/20/2014, for coronary heart disease was 8/3/2016, for stroke was 9/9/2016, and for heart failure was 1/20/2014. Time-varying PPI ever-use was ascertained using 1) natural language processing to capture unstructured text from the electronic health record, and 2) outpatient prescriptions. An incident CVD event was defined as the first occurrence of 1) validated heart failure, 2) validated coronary heart disease, or 3) stroke, defined using diagnostic codes only. As a secondary analysis, we calculated the association between time-varying H 2 -blocker ever-use and CVD among persons not using H 2 -blockers at baseline. Results: After adjustment for age, sex, race, education, hypertension, hyperlipidemia, diabetes, and body-mass-index, PPI use was associated with an approximately 50% higher risk of CVD (hazard ratio [95% CI]: 1.51 [1.37-1.67]; 2187 CVD events), stroke (hazard ratio [95% CI]: 1.49 [1.35-1.65]; 1928 stroke events), and heart failure (hazard ratio [95% CI]: 1.56 [1.23-1.97]; 353 heart failure events) compared to nonusers. Users of PPIs had a 35% greater risk of coronary heart disease than nonusers (95% CI: 1.13-1.61; 626 coronary heart disease events). Use of H 2 -blockers was also associated with a higher risk of CVD (adjusted hazard ratio [95% CI]: 1.23 [1.08-1.41]; 2331 CVD events). Conclusions: PPI use is associated with a higher risk of CVD, coronary heart disease, stroke and heart failure. Use of a drug with no known cardiac toxicity - H 2 -blockers - was also associated with a greater risk of CVD, warranting further study.

scholarly journals Efficacy and Safety of TCMI in Patients With Combined Coronary Heart Disease and Heart Failure: A Systematic Review and Network Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Penglu Wei ◽  
Kuo Yang ◽  
Dehuai Long ◽  
Yupei Tan ◽  
Wenlong Xing ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Effectiveness Rate

Objective: To compare the efficacy and safety of conventional treatments (CTs) to those that included traditional Chinese medicine injections (TCMIs) in patients with combined coronary heart disease and heart failure (CHD-HF).Methods: Eight electronic literature databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure Database, Chinese Scientific Journal Database, Wanfang Database, Chinese Biomedical Database) were searched from their inceptions to May 18, 2021, to identify relevant randomised controlled trials (RCTs). The primary outcomes analyzed included the total effectiveness rate and adverse events (ADRs). The secondary outcomes analyzed included the left ventricular ejection fraction (LVEF), N-terminal pro-brain natriuretic peptide (NT-proBNP), brain natriuretic peptide (BNP), and 6-min walk test (6MWT). Cochrane risk-of-bias tool was used to assess quality of the analyzed RCTs. Stata and OpenBUGS software were used to prior to the systematic review and network meta-analysis.Results: Sixty-one eligible trials involved 5,567 patients and one of the following 15 TCMIs: Shuxuetong, Shenmai, Shenfu, Shengmai, Danshenduofenyansuan, Danhong, Dazhuhongjingtian, Xinmailong, Dengzhanxixin, Gualoupi, Shuxuening, Xuesaitong, Yiqi Fumai, Shenqi Fuzheng, Huangqi. Network meta-analysis revealed that Shuxuetong injection + CT group was superior to CT only in improving the total effectiveness rate [odds ratio (OR): 7.8, 95% confidence interval (CI): 1.17–27.41]. Shenmai injection + CT was superior to CT only for LVEF (OR: 8.97, CI: 4.67–13.18), Xinmailong injection + CT was superior to CT only for NT-proBNP (OR: −317.70, CI: −331.10–303.10), Shenqi Fuzheng injection + CT was superior to CT only for BNP (OR: −257.30, CI: −308.40–242.80); and Danhong injection + CT was superior to CT only for 6MWT (OR: 84.40, CI: 62.62−106.20). Different TCMIs had different toxicity spectrums.Conclusion: TCMIs combined with CT are better than CT alone in treating CHD-HF. Different TCMIs improve different outcomes. Additional properly designed RCTs are needed to conduce a more refined comparison of various TCMIs.Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021258263].

Abstract 054: Diet Beverage Intake is Positively Associated With Incident Coronary Heart Disease in People With Type 2 Diabetes

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Andrew O Odegaard ◽  
Lyn M Steffen ◽  
David R Jacobs ◽  
Katherine L Tucker ◽  
Kenneth J Mukamal ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Meta Analysis ◽  
Health Concern ◽  
Cardiovascular Health Study ◽  
High Risk Population ◽  
Incident Coronary Heart Disease ◽  
Increased Risk

Introduction: Diet beverages are calorie free beverages sweetened with non-nutritive sweeteners. People with diabetes are the highest per-capita consumers of diet beverages, tending to consume them as a replacement for dietary sources of sugar, especially in place of sugar sweetened beverages. This behavior is endorsed by dietetic and scientific organizations and diet beverages are marketed synonymously with better health, weight loss, and thus, are considered advantageous for diabetes control. The underlying public health concern is the lack of data to support or refute this concept. Hypothesis: Higher diet beverage intake is positively associated with incident Coronary Heart Disease (CHD) Methods: We pooled the data sets of the Atherosclerosis Risk in Communities (ARIC) study (1987-2014), Cardiovascular Health Study (CHS) (1989-2014), Framingham Offspring Study (FOS) (1995-2014), Jackson Heart Study (JHS) (2000-2012), and Multi-Ethnic Study of Atherosclerosis (MESA (2000-2013) to conduct a prospective examination of the association of diet beverage intake with the incidence of CHD among participants with clinically ascertained type 2 diabetes (T2D) without prevalent CHD and with valid dietary data (N=3,947). We carried out a 2-step meta-analysis using individual level, cohort-specific Cox regression analyses with identical adjustment for demographic, lifestyle, overall diet quality and clinical risk factors to generate effect estimates that were pooled together using fixed and random effects meta-analysis. Results: 1,046 participants developed adjudicated CHD during follow-up. There was a positive, graded association between diet beverage intake and risk of incident CHD (Table). Results were consistent by sex, race and age. Conclusions: Diet beverage intake is associated with increased risk of developing CHD in a population with T2D. These results suggest the need to further evaluate dietary recommendations related to diet beverages and consider their role in this high risk population.

Coronary heart disease, heart failure, and the risk of dementia: A systematic review and meta-analysis

2018 ◽  
Vol 14 (11) ◽  
pp. 1493-1504 ◽  
Author(s):  
Frank J. Wolters ◽  
Reffat A. Segufa ◽  
Sirwan K.L. Darweesh ◽  
Daniel Bos ◽  
Mohammad Arfan Ikram ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Meta Analysis

scholarly journals Association of Sex, Age, and Comorbidities with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis

Intervirology ◽  
2020 ◽  
pp. 1-12
Author(s):  
Mohitosh Biswas ◽  
Shawonur Rahaman ◽  
Tapash Kumar Biswas ◽  
Zahirul Haque ◽  
Baharudin Ibrahim
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Considerable Proportion ◽  
Relative Risks ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Male Patients ◽  
Reduce Risk

<b><i>Introduction:</i></b> Although severe acute respiratory syndrome coronavirus-2 infection is causing mortality in considerable proportion of coronavirus disease-2019 (COVID-19) patients, however, evidence for the association of sex, age, and comorbidities on the risk of mortality is not well-aggregated yet. It was aimed to assess the association of sex, age, and comorbidities with mortality in COVID-2019 patients. <b><i>Methods:</i></b> Literatures were searched using different keywords in various databases. Relative risks (RRs) were calculated by RevMan software where statistical significance was set as <i>p</i> &#x3c; 0.05. <b><i>Results:</i></b> COVID-19 male patients were associated with significantly increased risk of mortality compared to females (RR 1.86: 95% confidence interval [CI] 1.67–2.07; <i>p</i> &#x3c; 0.00001). Patients with age ≥50 years were associated with 15.4-folds significantly increased risk of mortality compared to patients with age &#x3c;50 years (RR 15.44: 95% CI 13.02–18.31; <i>p</i> &#x3c; 0.00001). Comorbidities were also associated with significantly increased risk of mortality; kidney disease (RR 4.90: 95% CI 3.04–7.88; <i>p</i> &#x3c; 0.00001), cereborovascular disease (RR 4.78; 95% CI 3.39–6.76; <i>p</i> &#x3c; 0.00001), cardiovascular disease (RR 3.05: 95% CI 2.20–4.25; <i>p</i> &#x3c; 0.00001), respiratory disease (RR 2.74: 95% CI 2.04–3.67; <i>p</i> &#x3c; 0.00001), diabetes (RR 1.97: 95% CI 1.48–2.64; <i>p</i> &#x3c; 0.00001), hypertension (RR 1.95: 95% CI 1.58–2.40; <i>p</i> &#x3c; 0.00001), and cancer (RR 1.89; 95% CI 1.25–2.84; <i>p</i> = 0.002) but not liver disease (RR 1.64: 95% CI 0.82–3.28; <i>p</i>= 0.16). <b><i>Conclusion:</i></b> Implementation of adequate protection and interventions for COVID-19 patients in general and in particular male patients with age ≥50 years having comorbidities may significantly reduce risk of mortality associated with COVID-19.

scholarly journals Cardiac Dysfunction in Rheumatoid Arthritis: The Role of Inflammation

Cells ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 881
Author(s):  
Jianmin Chen ◽  
Lucy V. Norling ◽  
Dianne Cooper
Keyword(s):  
Rheumatoid Arthritis ◽  
Heart Failure ◽  
Cardiovascular Disease ◽  
Heart Disease ◽  
Cardiac Dysfunction ◽  
Preserved Ejection Fraction ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Systemic Inflammatory Disease

Rheumatoid arthritis is a chronic, systemic inflammatory disease that carries an increased risk of mortality due to cardiovascular disease. The link between inflammation and atherosclerotic disease is clear; however, recent evidence suggests that inflammation may also play a role in the development of nonischemic heart disease in rheumatoid arthritis (RA) patients. We consider here the link between inflammation and cardiovascular disease in the RA community with a focus on heart failure with preserved ejection fraction. The effect of current anti-inflammatory therapeutics, used to treat RA patients, on cardiovascular disease are discussed as well as whether targeting resolution of inflammation might offer an alternative strategy for tempering inflammation and subsequent inflammation-driven comorbidities in RA.

scholarly journals Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis

BMJ ◽  
2020 ◽  
pp. m2297 ◽  
Author(s):  
Xiaoyan Cai ◽  
Yunlong Zhang ◽  
Meijun Li ◽  
Jason HY Wu ◽  
Linlin Mai ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
General Population ◽  
Confidence Interval ◽  
Absolute Risk ◽  
Meta Analysis ◽  
Atherosclerotic Cardiovascular Disease ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Objective To evaluate the associations between prediabetes and the risk of all cause mortality and incident cardiovascular disease in the general population and in patients with a history of atherosclerotic cardiovascular disease. Design Updated meta-analysis. Data sources Electronic databases (PubMed, Embase, and Google Scholar) up to 25 April 2020. Review methods Prospective cohort studies or post hoc analysis of clinical trials were included for analysis if they reported adjusted relative risks, odds ratios, or hazard ratios of all cause mortality or cardiovascular disease for prediabetes compared with normoglycaemia. Data were extracted independently by two investigators. Random effects models were used to calculate the relative risks and 95% confidence intervals. The primary outcomes were all cause mortality and composite cardiovascular disease. The secondary outcomes were the risk of coronary heart disease and stroke. Results A total of 129 studies were included, involving 10 069 955 individuals for analysis. In the general population, prediabetes was associated with an increased risk of all cause mortality (relative risk 1.13, 95% confidence interval 1.10 to 1.17), composite cardiovascular disease (1.15, 1.11 to 1.18), coronary heart disease (1.16, 1.11 to 1.21), and stroke (1.14, 1.08 to 1.20) in a median follow-up time of 9.8 years. Compared with normoglycaemia, the absolute risk difference in prediabetes for all cause mortality, composite cardiovascular disease, coronary heart disease, and stroke was 7.36 (95% confidence interval 9.59 to 12.51), 8.75 (6.41 to 10.49), 6.59 (4.53 to 8.65), and 3.68 (2.10 to 5.26) per 10 000 person years, respectively. Impaired glucose tolerance carried a higher risk of all cause mortality, coronary heart disease, and stroke than impaired fasting glucose. In patients with atherosclerotic cardiovascular disease, prediabetes was associated with an increased risk of all cause mortality (relative risk 1.36, 95% confidence interval 1.21 to 1.54), composite cardiovascular disease (1.37, 1.23 to 1.53), and coronary heart disease (1.15, 1.02 to 1.29) in a median follow-up time of 3.2 years, but no difference was seen for the risk of stroke (1.05, 0.81 to 1.36). Compared with normoglycaemia, in patients with atherosclerotic cardiovascular disease, the absolute risk difference in prediabetes for all cause mortality, composite cardiovascular disease, coronary heart disease, and stroke was 66.19 (95% confidence interval 38.60 to 99.25), 189.77 (117.97 to 271.84), 40.62 (5.42 to 78.53), and 8.54 (32.43 to 61.45) per 10 000 person years, respectively. No significant heterogeneity was found for the risk of all outcomes seen for the different definitions of prediabetes in patients with atherosclerotic cardiovascular disease (all P>0.10). Conclusions Results indicated that prediabetes was associated with an increased risk of all cause mortality and cardiovascular disease in the general population and in patients with atherosclerotic cardiovascular disease. Screening and appropriate management of prediabetes might contribute to primary and secondary prevention of cardiovascular disease.

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