scholarly journals Pharmacist-involved care for patients with heart failure and acute coronary syndrome: a systematic review with qualitative and quantitative meta-analysis

2016 ◽  
Vol 41 (2) ◽  
pp. 145-157 ◽  
Author(s):  
J. E. Kang ◽  
N. Y. Han ◽  
J. M. Oh ◽  
H. K. Jin ◽  
H. A. Kim ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Acute Coronary Syndrome ◽  
Meta Analysis ◽  
Qualitative And Quantitative ◽  
Coronary Syndrome ◽  
Patients With Heart Failure

Abstract 3215: Effects of Selective and Non-Selective Beta-Blockers on Cardiovascular Risk in Patients with Heart Failure or Acute Coronary Syndrome: a Meta-Analysis.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Olav R de Peuter ◽  
Federico Lussana ◽  
Pieter W Kamphuisen
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Cardiovascular Mortality ◽  
Beta Blockers ◽  
Meta Analysis ◽  
Total Mortality ◽  
Cochrane Library ◽  
Mortality And Morbidity ◽  
Coronary Syndrome ◽  
Patients With Heart Failure

Background: Guidelines generally recommend the use of beta-blockers in patients with heart failure (HF) and acute coronary syndrome (ACS). It has recently been suggested that non-selective beta-blockers were more effective than selective beta-blockers in HF. However, a better efficacy of different beta-blockers, specifically analyzing total and cardiovascular (CV) mortality and morbidity, in patients with HF or ACS is unclear. Methods: We performed a meta-analysis of randomized controlled trials (RCTs) through Medline, EMBASE, and Cochrane Library databases to identify RCTs comparing selective or non-selective beta-blockers with placebo (29 studies, 31,856 patients), or directly comparing the two different beta-blockers (5 studies, 3,733 patients). Studies were selected using a priori defined criteria and data on study characteristics, study quality and outcomes were abstracted. All included studies had (cardiovascular) mortality as primary or secondary endpoint. Results: In patients with HF non-selective beta-blockers were associated with a reduction in total mortality (RR 0.75, 95%CI 0.61–0.92), and with a non significant decrease in CV mortality. Selective beta-blockers decreased total and CV mortality (RR 0.76, 0.68–0.84 and RR 0.78, 0.66–0.92, respectively). In patients with ACS non-selective beta-blockers were associated with a significant decrease in total mortality (RR 0.73, 0.64–0.82), CV mortality (RR 0.69, 0.60–0.80) and CV morbidity. Selective beta-blockers however had no effect on total mortality (RR 0.88, 0.68–1.15) or CV mortality (RR 0.89, 0.69–1.15). In HF, direct comparison showed a significantly decreased mortality (RR 0.86, 0.78–0.94) for non-selective beta-blockers compared to selective beta-blockers. For ACS, only one study directly compared different beta-blockers. Conclusions: In patients with HF, selective and non-selective beta-blockers seem equally effective in reducing mortality. In patients with ACS, selective beta-blockers had no influence on total and cardiovascular mortality, in contrast to non-selective beta-blockers. This meta-analysis suggests that patients with ACS should specifically be treated with non-selective beta-blockers to reduce total and cardiovascular mortality.

scholarly journals Association of Obstructive Sleep Apnea With the Risk of Repeat Adverse Cardiovascular Events in Patients With Newly Diagnosed Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 014556132198945
Author(s):  
Shu-Han Yang ◽  
Yong-Sheng Xing ◽  
Zeng-Xia Wang ◽  
Yan-Bin Liu ◽  
Hong-Wei Chen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Obstructive Sleep Apnea ◽  
Acute Coronary Syndrome ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Newly Diagnosed ◽  
Repeat Revascularization ◽  
Coronary Syndrome ◽  
Obstructive Sleep

Background: The impact of obstructive sleep apnea (OSA) on subsequent cardiovascular events in patients with acute coronary syndrome (ACS) remains inconclusive. Aim: Our aim was to systematically assess the relationship between preexisting OSA and adverse cardiovascular events in patients with newly diagnosed ACS by conducting a systematic review and meta-analysis. Methods: We systematically searched PubMed, EMBASE, and Cochrane library for studies published up to May 1, 2020, that reported any association between OSA and cardiovascular events in patients with newly diagnosed ACS. The main outcomes were a composite of all-cause or cardiovascular death, recurrent myocardial infarction, stroke, repeat revascularization, or heart failure. We conducted a pooled analysis using the random-effects model. We also performed subgroup, sensitivity, heterogeneity analysis, and the assessment of publication bias. Results: We identified 10 studies encompassing 3350 participants. The presence of OSA was associated with increased risk of adverse cardiovascular events in newly prognosed ACS (risk ratio [RR] 2.18, 95% confidence interval [CI]: 1.45-3.26, P < .001, I 2 = 64%). Between-study heterogeneity was partially explained by a multicenter study (9 single-center studies, RR 2.33 95% CI 1.69-3.19, I 2 =18%), and I 2 remarkably decreased from 64% to 18%. Moreover, OSA significantly increased the incidence of repeat revascularization (8 studies) and heart failure (6 studies) in patients with newly diagnosed ACS. Conclusion: Patients with preexisting OSA are at greater risk of subsequent cardiovascular events after onset of ACS. Further studies should investigate the treatment of OSA in patient with ACS.

scholarly journals Prediction of all-cause mortality with malnutrition assessed by controlling nutritional status score in patients with heart failure: a systematic review and meta-analysis

2021 ◽  
pp. 1-8
Author(s):  
Huiyang Li ◽  
Peng Zhou ◽  
Yikai Zhao ◽  
Huaichun Ni ◽  
Xinping Luo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Nutritional Status ◽  
Meta Analysis ◽  
Predictive Values ◽  
Increased Risk ◽  
Patients With Heart Failure ◽  
All Cause Mortality ◽  
Conut Score

Abstract Objective: The aim of this meta-analysis was to investigate the association between malnutrition assessed by the controlling nutritional status (CONUT) score and all-cause mortality in patients with heart failure. Design: Systematic review and meta-analysis. Settings: A comprehensively literature search of PubMed and Embase databases was performed until 30 November 2020. Studies reporting the utility of CONUT score in prediction of all-cause mortality among patients with heart failure were eligible. Patients with a CONUT score ≥2 are grouped as malnourished. Predictive values of the CONUT score were summarized by pooling the multivariable-adjusted risk ratios (RR) with 95 % CI for the malnourished v. normal nutritional status or per point CONUT score increase. Participants: Ten studies involving 5196 patients with heart failure. Results: Malnourished patients with heart failure conferred a higher risk of all-cause mortality (RR 1·92; 95 % CI 1·58, 2·34) compared with the normal nutritional status. Subgroup analysis showed the malnourished patients with heart failure had an increased risk of in-hospital mortality (RR 1·78; 95 % CI 1·29, 2·46) and follow-up mortality (RR 2·01; 95 % CI 1·58, 2·57). Moreover, per point increase in CONUT score significantly increased 16% risk of all-cause mortality during the follow-up. Conclusions: Malnutrition defined by the CONUT score is an independent predictor of all-cause mortality in patients with heart failure. Assessment of nutritional status using CONUT score would be helpful for improving risk stratification of heart failure.

Catheter ablation of atrial fibrillation in patients with heart failure with preserved ejection fraction: a systematic review and meta-analysis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
O.M Aldaas ◽  
F Lupercio ◽  
C.L Malladi ◽  
P.S Mylavarapu ◽  
D Darden ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Systematic Review ◽  
Catheter Ablation ◽  
Ejection Fraction ◽  
Meta Analysis ◽  
Preserved Ejection Fraction ◽  
Patients With Heart Failure ◽  
One Year

Abstract Background Catheter ablation improves clinical outcomes in symptomatic atrial fibrillation (AF) patients with heart failure (HF) with reduced ejection fraction (HFrEF). However, the role of catheter ablation in HF patients with a preserved ejection fraction (HFpEF) is less clear. Purpose To determine the efficacy of catheter ablation of AF in patients with HFpEF relative to those with HFrEF. Methods We performed an extensive literature search and systematic review of studies that compared AF recurrence at one year after catheter ablation of AF in patients with HFpEF versus those with HFrEF. Risk ratio (RR) 95% confidence intervals were measured using the Mantel-Haenszel method for dichotomous variables, where a RR&lt;1.0 favors the HFpEF group. Results Four studies with a total of 563 patients were included, of which 312 had HFpEF and 251 had HFrEF. All patients included were undergoing first time catheter ablation of AF. Patients with HFpEF experienced similar recurrence of AF one year after ablation on or off antiarrhythmic drugs compared to those with HFrEF (RR 0.87; 95% CI 0.69–1.10, p=0.24), as shown in Figure 1. Recurrence of AF was assessed with electrocardiography, Holter monitoring, and/or event monitoring at scheduled follow-up visits and final follow-up. Conclusion Based on the results of this meta-analysis, catheter ablation of AF in patients with HFpEF appears as efficacious in maintaining sinus rhythm as in those with HFrEF. Funding Acknowledgement Type of funding source: None

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