scholarly journals Yanyu Decoction for Aged Patients with Stable Coronary Artery Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Shihua Shi ◽  
Zhenxing Wang ◽  
Siming Li ◽  
Xiaoping Wu ◽  
Peili Wang ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiovascular Events ◽  
Blood Lipids ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Cardiac Mortality ◽  
Aged Patients ◽  
Artery Disease ◽  
Stable Cad

Background. There was limited evidence of treatments aiming at aged coronary artery disease (CAD) patients. Yanyu decoction (YD) has been used as adjuvant therapy in aged patients with stable CAD and might be a new treatment worthy of recommendation for CAD patients. This study was to evaluate the combined effects of YD plus conventional pharmaceutical treatment (CPT) on senile patients with stable CAD. Methods. This review was designed according to the PRISMA (Preferred Reported Items for Systematic Reviews and Meta-Analysis) recommendations. A literature search was conducted in seven electronic databases from their inception until August 2020. Primary outcomes of interest were adverse cardiovascular events, including cardiac mortality, acute myocardial infarction (AMI), and unstable angina (UA). The secondary outcomes were blood lipids and hemorheology. Studies were pooled to calculate the risk ratio or weighted mean difference and corresponding 95% confidence interval. Results. Five studies recruiting 848 aged patients with stable CAD were included. Patients receiving YD as an adjuvant have fewer adverse cardiovascular events, including cardiac mortality, AMI, and UA. Besides, YD plus CPT has a better effect on reducing triglycerides, low-density lipoprotein cholesterol, and improving high-density lipoprotein cholesterol. Moreover, significant effects of YD plus CPT for reducing blood viscosity, plasma viscosity, and platelet aggregation rate were found compared with CPT alone. Conclusion. YD plus CPT showed better efficacy than CPT on reducing adverse cardiovascular events and improving hemorheology and blood lipids for aged patients with stable CAD. Our findings may suggest YD as an adjuvant natural-based treatment for CAD. However, more rigorous and larger trials are essential to validate our results, and further consideration of CAD studies specific to aged patients is needed.

Benefits and Harm of Treatment with P2Y12 Inhibitors beyond 12 Months in Patients with Coronary Artery Disease

2019 ◽  
Vol 46 (04) ◽  
pp. 446-456
Author(s):  
Mads Lamm Larsen ◽  
Erik Lerkevang Grove ◽  
Steen Dalby Kristensen ◽  
Anne-Mette Hvas
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
P2y12 Inhibitors ◽  
Coronary Syndrome ◽  
Major Cardiovascular Events ◽  
Significant Difference ◽  
Artery Disease ◽  
Stable Cad

AbstractThe trade-off between the benefits and harm of long-term (> 12 months) treatment with P2Y12 inhibitors in patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI) remains controversial. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed and Embase were searched without time restrictions to identify randomized controlled trials comparing > 12-month P2Y12 inhibition versus ≤ 12-month treatment in patients with acute coronary syndrome (ACS) or stable CAD undergoing PCI. A qualitative assessment was performed using the assessment tool from the National Heart, Lung, and Blood Institute of the National Institutes of Health. We performed a meta-analysis of the following endpoints: primary outcome (primarily major cardiovascular events), all-cause death, and major bleeding. Eight trials, comprising 40,218 patients, were included. Five studies were rated “good,” two studies “fair,” and one study “poor.” The meta-analysis showed that > 12-month P2Y12 inhibition significantly reduced the primary outcomes compared with ≤ 12-month treatment (hazard ratio [HR]: 0.85; 95% confidence interval (CI): 0.75–0.97; p = 0.01). No significant difference was demonstrated between groups in all-cause death (HR: 1.02; 95% CI: 0.76–1.36; p = 0.91) or major bleedings (HR: 1.26; 95% CI: 0.93–1.70; p = 0.14). I 2 test showed low to moderate heterogeneity among the included studies (21.6–62.3%). This systematic review and meta-analysis therefore demonstrates a reduction in major cardiovascular events during extended P2Y12-inhibitor treatment beyond 12 months compared with ≤ 12 months in patients with ACS or stable CAD undergoing PCI. There was no significant difference in all-cause death or major bleedings.

scholarly journals Plasma PCSK9 concentrations predict Cardiovascular Events in subjects free of vascular disease and with stable coronary artery disease: Findings from a community-based prospective study and a meta-analysis

2020 ◽  
Author(s):  
Xiaona Wang ◽  
Yongyi Bai ◽  
Ruihua Cao ◽  
Xu Yang ◽  
Wenkai Xiao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Community Based ◽  
Cox Regression Analysis ◽  
Prospective Cohorts ◽  
Artery Disease ◽  
Stable Cad

Abstract Background The secreted protein proprotein convertase subtilisin/kexin type 9 (PCSK9) is a promising new target for lowering plasma low-density lipoprotein cholesterol and preventing cardiovascular disease. Objective We aimed to determine the relationship between PCSK9 levels and cardiovascular (CV) events using a large cohort and a systematic review with meta-analysis. Methods We analyzed the association of plasma PCSK9 levels with CV events in 1324 subjects (mean age, 61.3 years) from a community-based population in Beijing, China. For the systematic review, we pooled the results of our cohort with other eligible studies in a meta-analysis using a random effects model. Results After a median follow-up interval of 4.8 years, 79 CV events were identified. Cox regression analysis showed that the presence of CV events (HR: 1.83, 95% CI, 1.07-3.17; P=0.046) was related to PCSK9 levels significantly. Combining another 8 prospective cohorts and our findings in a meta-analysis (9 prospective cohorts with a total of 13013 participants were included) showed a positive association between plasma PCSK9 levels and CV events, with a summary HR of 1.26 (95% CI: 1.07-1.50; P=0.007). When pooled estimates were derived for pre-existent and free of coronary artery disease (CAD) populations, baseline PCSK9 levels predicted total CV events only in subjects free of CAD (pooled HR: 1.34, 95% CI, 1.11-1.61; P=0.003). In patients with pre-existent CAD, further subgroup analysis showed that baseline PCSK9 levels predicted CV events only in subjects with stable CAD (pooled HR: 1.58, 95% CI, 1.04-2.38; P=0.030) but not in patients with unstable CAD (pooled HR: 1.02, 95% CI, 0.76-1.35; P=0.908). Conclusion Our findings in the Chinese cohort and the meta-analysis support that high plasma PCSK9 level was a predictive factor for future CV events in subjects free of CAD and with stable CAD but not in patients with established unstable CAD. Keywords PCSK9; cardiovascular events; cohort; meta-analysis.

Relationship Between Platelet to Lymphocyte Ratio and Stable Coronary Artery Disease: Meta-Analysis of Observational Studies

Angiology ◽  
2020 ◽  
Vol 71 (10) ◽  
pp. 909-915
Author(s):  
Zhiqiang Qiu ◽  
Yu Jiang ◽  
Xinghua Jiang ◽  
Renqiang Yang ◽  
Yanqing Wu ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Collateral Circulation ◽  
Meta Analysis ◽  
Stable Coronary Artery Disease ◽  
Current Evidence ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Artery Disease ◽  
Stable Cad

Recent studies have reported a relationship between the platelet to lymphocyte ratio (PLR) and acute coronary syndromes. The aim of the present study was to investigate the association between PLR and stable coronary artery disease (CAD). A systematic search was conducted based on electronic databases (Cochrane, PubMed, Elsevier, Medline, and Embase). A total of 14 studies (n = 4,871) were included in the meta-analysis. Compared with the non-CAD group, PLR was significantly higher in CAD group ( P = .002). After further classification according to the Gensini score, the cases with atherosclerosis demonstrated a higher PLR than those without atherosclerosis ( P < .001). Platelet to lymphocyte ratio was higher in the severe atherosclerosis group compared with the mild atherosclerosis group ( P < .001). Compared with the poor coronary collateral circulation (CCC) group, PLR was significantly lower in the good CCC group ( P < .001). The PLR was significantly higher in patients with coronary slow flow (CSF) than those with normal coronary flow ( P = .01). On the basis of current evidence, an elevated PLR was associated with stable CAD, and it might be useful for predicting CAD severe stenosis, collateral circulation, and CSF. Future studies are needed to clarify the relationship between PLR and stable CAD.

Increased Peripheral Blood Visfatin Concentrations May Be a Risk Marker of Coronary Artery Disease: A Meta-Analysis of Observational Studies

Angiology ◽  
2018 ◽  
Vol 69 (9) ◽  
pp. 825-834 ◽  
Author(s):  
Fuling Yu ◽  
Jianwei Li ◽  
Qilei Huang ◽  
Hongbin Cai
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Peripheral Blood ◽  
Observational Studies ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Risk Marker ◽  
Regression Analyses ◽  
Meta Regression ◽  
Artery Disease

A comprehensive quantitative evaluation of the relationship between peripheral blood visfatin concentrations and coronary artery disease (CAD) is lacking. This study is the first attempt to quantify this relationship via a meta-analysis of published observational studies in terms of weighted mean difference (WMD). Literature retrieval, article selection, and data extraction were conducted. Heterogeneity was inspected using both subgroup and meta-regression analyses. In total, 15 articles involving 1053 CAD cases and 714 controls were included. Overall, peripheral blood visfatin concentrations were significantly higher in CAD cases than in controls (WMD: 4.72 ng/mL; 95% confidence interval [CI]: 2.97-6.47; P < .001), with significant heterogeneity and publication bias. Six studies were theoretically missing based on filled funnel plot, and considering the impact of these missing studies still detected a significant overall mean difference in visfatin (WMD: 2.82 ng/mL; 95% CI: 2.22-3.58; P < .001; number of studies: 21). Subgroup and meta-regression analyses indicated age, body mass index, race, diabetes, systolic blood pressure, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were identified as possible causes of heterogeneity. In conclusion, our findings suggest that increased peripheral blood visfatin concentrations may be a risk marker of CAD.

Associations of the Polymorphisms in ADIPOQ with Circulating Levels of Adiponectin and Lipids: A Meta-Analysis

2021 ◽  
Vol 53 (08) ◽  
pp. 541-561
Author(s):  
Mi Su ◽  
Aimei Jia ◽  
Yilan He ◽  
Yongyan Song
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Confidence Interval ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Random Effects Model ◽  
Adiponectin Gene ◽  
Standardized Mean Difference ◽  
Artery Disease ◽  
Circulating Levels

AbstractThe relationships between the rs266729, rs1501299, and rs2241766 polymorphisms in adiponectin gene (ADIPOQ) and circulating levels of adiponectin and lipids remain to be clarified. Databases including PubMed and Embase were searched for eligible studies. The random-effects model was used, and standardized mean difference (SMD) with 95% confidence interval (CI) was calculated to estimate the differences in circulating levels of adiponectin and lipids between the subjects with different genotypes. A total of 12 810, 17 319, and 21 361 subjects were identified in the analyses for the rs266729, rs1501299, and rs2241766 polymorphisms, respectively. G allele carriers of the rs266729 polymorphism had lower levels of adiponectin (SMD=–0.28, 95% CI=–0.43 to–0.12) and high-density lipoprotein cholesterol (HDL-C) (SMD=–0.10, 95% CI=–0.17 to–0.02) than CC homozygotes; T allele carriers of the rs1501299 polymorphism had higher levels of adiponectin (SMD=0.21, 95% CI=0.05 to 0.36) and HDL-C (SMD=0.09, 95% CI=0.04 to 0.15) and lower levels of triglycerides (SMD=–0.06, 95% CI=–0.12 to–0.01) than GG homozygotes; G allele carriers of the rs2241766 polymorphism had lower levels of adiponectin (SMD=–0.18, 95% CI=–0.31 to–0.05) and HDL-C (SMD=–0.12, 95% CI=–0.20 to–0.04) than TT homozygotes. This meta-analysis suggests that the rs266729, rs1501299, and rs2241766 polymorphisms of ADIPOQ are significantly associated with circulating levels of adiponectin and lipids, which may partly explain the associations between these polymorphisms and coronary artery disease.

Rheumatoid Arthritis and Coronary Artery Disease: Genetic Analyses Do Not Support a Causal Relation

2016 ◽  
Vol 44 (1) ◽  
pp. 4-10 ◽  
Author(s):  
Henning Jansen ◽  
Christina Willenborg ◽  
Wolfgang Lieb ◽  
Lingyao Zeng ◽  
Paola Gloria Ferrario ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Inflammatory Diseases ◽  
Causal Relation ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Nucleotide Polymorphisms ◽  
Genome Wide ◽  
Artery Disease

Objective.Inflammatory diseases, specifically rheumatoid arthritis (RA), are assumed to increase the risk of coronary artery disease (CAD). More recently, multiple single-nucleotide polymorphisms (SNP) associated with RA risk were identified. If causal mechanisms affecting risks of RA and CAD are overlapping, risk alleles for RA might also increase the risk of CAD.Methods.Sixty-one SNP associating with RA in genome-wide significant analyses were tested for association with CAD in CARDIoGRAM (Coronary ARtery DIsease Genome wide Replication and Meta-analysis), a metaanalysis including genome-wide association data (22,233 CAD cases, 64,762 controls). In parallel, a set of SNP being associated with low-density lipoprotein cholesterol (LDL-C) was tested as a positive control.Results.Twenty-nine RA-associated SNP displayed a directionality-consistent association with CAD (OR range 1.002–1.073), whereas 32 RA-associated SNP were not associated with CAD (OR range 0.96–0.99 per RA risk-increasing allele). The proportion (48%) of directionality-consistent associated SNP equaled the proportion expected by chance (50%, p = 0.09). Of only 5 RA-associated SNP showing p values for CAD < 0.05, 4 loci (C5orf30, IL-6R, PTPN22, and RAD51B) showed directionality-consistent effects on CAD, and 1 (rs10774624, locus SH2B3) reached study-wide significance (p = 7.29E-06). By contrast, and as a proof of concept, 46 (74%) out of 62 LDL-C–associated SNP displayed a directionality-consistent association with CAD, a proportion that was significantly different from 50% (p = 5.9E-05).Conclusion.We found no evidence that RA-associated SNP as a group are associated with CAD. Even though we were not able to study potential effects of all genetic variants individually, shared nongenetic factors may more plausibly explain the observed coincidence of the 2 conditions.

Sign in / Sign up

Export Citation Format

Share Document