scholarly journals Revascularization versus Medical Management of Coronary Artery Disease in Prerenal Transplant Patients: A Meta-Analysis

2018 ◽  
Vol 8 (3) ◽  
pp. 192-198
Author(s):  
Haroon Kamran ◽  
Eric Kupferstein ◽  
Navneet Sharma ◽  
Gagandeep Singh ◽  
James R. Sowers ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Renal Transplantation ◽  
Coronary Artery ◽  
Medical Management ◽  
Odds Ratio ◽  
Patient Population ◽  
Fixed Effects ◽  
Coronary Revascularization ◽  
Meta Analysis ◽  
Artery Disease

Introduction: End-stage renal disease requiring renal transplantation comprises a growing patient population at risk for cardiovascular disease (CVD) morbidity and mortality in large part due to accelerated atherosclerosis. Consequently, these patients are at even higher risk of major surgical CVD mortality. A paucity of research has addressed the posttransplantation CVD outcomes related to different treatment strategies in this patient population and therefore, there are no specific preoperative guidelines regarding management of coronary artery disease in this high-risk population undergoing renal transplantation. Objective: Through meta-analysis we compare coronary revascularization to medical management prior to renal transplantation in patients who are found to have significant obstructive coronary artery disease. Results: A total of 6 studies were deemed suitable out of 777 articles reviewed. This included 260 patients who received medical management and 338 who received coronary revascularization. There were 36 events in the revascularization and 57 events in the medical management group. One study only reported hazard ratios but no CVD outcomes. Comprehensive Meta-Analysis software was used to calculate pooled odds ratio with 95% confidence intervals (CI) for the fixed effects. The data is presented as forest plots. The pooled odds ratio with 95% CI for the fixed effects was 1.415 (95% CI 0.885–2.263), p = 0.147, indicating that there is no difference in CVD outcomes between pretransplant treatment strategy. This observation suggests that the CVD outcomes posttransplantation are not affected when optimal medical therapy is used instead of coronary revascularization.

Abstract 13212: Cardiovascular Benefits of Apabetalone: A Meta-analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Hang Long Li ◽  
Qi Feng ◽  
Yue Fei ◽  
bernard cheung
Keyword(s):  
Heart Failure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Fixed Effects ◽  
Coronary Revascularization ◽  
Meta Analysis ◽  
Phase Iii ◽  
Cochrane Library ◽  
Phase Ii Trials ◽  
Artery Disease

Introduction: Apabetalone is a novel drug that reduces inflammation and thrombosis by inhibiting bromodomain and extra-terminal proteins (BET). Three phase II trials suggested benefits whereas the recent phase III BETonMACE trial did not. To reconcile these differences, we performed a meta-analysis of all trials on apabetalone. Methods: MEDLINE, EMBASE, Cochrane Library, and ClinialTrials.gov were searched for randomized controlled trials of apabetalone up to May 05, 2020. The outcomes of interest were major adverse cardiovascular events (MACE) and hospitalization for heart failure. The secondary outcomes were death, myocardial infarction (MI), coronary revascularization, high-density lipoprotein (HDL) and apolipoprotein A-I (apoA-I). Pooled risk ratios (RRs) or mean differences (MD) in a fixed-effects model were generated using the “ meta ” package in R (version 3.6.3). Results: Four trials (median follow-up 3-26.5 months) with altogether 3223 patients were included. All patients had coronary artery disease and received standard statin therapy. Apabetalone significantly reduced MACE (RR 0.78, 95% CI: 0.63-0.96) and hospitalization for heart failure (RR 0.48, 95% CI: 0.33-0.70) compared to placebo (Fig.). No significant differences were observed for death (RR 0.87, 95% CI: 0.63-1.21), MI (RR 0.82, 95% CI: 0.62-1.10), or coronary revascularization (RR 0.67, 95% CI: 0.31-1.49). Apabetalone increased ApoA-I (MD 2.82%, 95% CI: 1.36-4.28) and HDL (MD 0.04%, 95% CI: 0.02-0.07). Conclusions: Although the BETonMACE trial failed to demonstrate significant benefits, our meta-analysis shows that apabetalone reduces MACE and hospitalization for heart failure in patients with coronary artery disease. Larger outcome trials are urgently needed to investigate the benefits of epigenetic modulation through BET protein inhibition.

Genetic variants of PEAR1 and ischemic clinical outcomes in coronary artery disease patients: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Xinyi Zhang ◽  
Sicong Li ◽  
Yuxuan Zhao ◽  
Ningjia Tang ◽  
Tong Jia ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Clinical Outcomes ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Electronic Database ◽  
Artery Disease ◽  
Relationship Of ◽  
The Relationship ◽  
Ischemic Events

Aim: The aim of this study was to assess the association between PEAR1 polymorphisms and ischemic clinical outcomes. Materials & methods: We searched the electronic database for articles on the relationship of PEAR1 SNPs and ischemic events in patients with coronary artery disease (CAD) up to October 2020. Results: A total of 9914 patients with CAD from six studies focusing on 12 SNPs of PEAR1 were included in this study. The A allele of rs12041331 were associated with ischemic events (odds ratio: 1.40; 95% CI: 1.04–1.88; p = 0.03). The AA homozygotes of rs2768759 was related to a higher risk of ischemic events than carriers of the C allele (odds ratio: 2.08; 95% CI: 1.09–3.97; p = 0.03). Conclusion: PEAR1 rs12041331 and rs2768759 are significantly associated with ischemic events in patients with CAD.

scholarly journals Effect of Potent P2Y12 Inhibitors on Ventricular Arrhythmias and Cardiac Dysfunction in Coronary Artery Disease: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-11
Author(s):  
Chunmei Wang ◽  
Guanqi Zhao ◽  
Xiao Wang ◽  
Shaoping Nie
Keyword(s):  
Systematic Review ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Dysfunction ◽  
Ventricular Arrhythmias ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Cochrane Central Register ◽  
Artery Disease

Background. Previous studies have shown that P2Y12 receptor inhibitors might prevent ventricular arrhythmias and cardiac dysfunction in patients with coronary artery disease. However, few studies have focused on comparison of the efficacy of novel oral potent P2Y12 receptor inhibitors with clopidogrel on these outcomes. Methods and Results. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) that were published in electronic databases of MEDLINE, EMBASE, Cochrane Central Register of Clinical Trials, and ClinicalTrials.gov before June 20, 2018. We compared the effect of prasugrel and ticagrelor with clopidogrel on outcomes of ventricular tachycardia (VT), ventricular fibrillation (VF), heart failure (HF), and cardiogenic shock (CS). Data were combined using both the fixed-effects models and the random-effects models, and the heterogeneity was assessed with the I2 statistic. Nine RCTs (6 with prasugrel and 3 with ticagrelor) with 45,227 patients were included. Patients receiving prasugrel were associated with a lower risk of combined VT and VF (rate ratio [RR]: 0.72, 95% confidence interval [CI]: 95% CI: 0.52-0.99, p=0.043), as well as combined HF and CS (RR: 0.81, 95% CI: 0.70-0.94, p=0.005), compared with clopidogrel. Patients receiving ticagrelor were also associated with a reduced risk of VT and VF (RR: 0.85, 95% CI: 0.72-1.02, p=0.077), although without statistical significance, but not of HF and CS (RR: 0.96, 95% CI: 0.81-1.13, p=0.620). Conclusions. This meta-analysis of RCTs shows that, compared with clopidogrel, novel oral P2Y12 inhibitors, especially prasugrel, might have better effect on improving ventricular rhythm and cardiac function.

scholarly journals The effect of polymorphisms (174G> C and 572C> G) on the Interleukin-6 gene in coronary artery disease: a systematic review and meta-analysis

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Nader Salari ◽  
Kamran Mansouri ◽  
Amin Hosseinian-Far ◽  
Hooman Ghasemi ◽  
Masoud Mohammadi ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Interleukin 6 ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Serum Levels ◽  
Protective Effects ◽  
Increased Risk ◽  
Artery Disease ◽  
The Relationship

Abstract Background Coronary Artery Disease (CAD) is caused by the blockage of the coronary arteries. it is argued that there has an association between the Interleukin-6 gene and the occurrence of atherosclerosis, coronary artery disease, Due to the short half-life and high variability of Interleukin-6 (IL-6), limited studies have been performed on the association of serum levels of interleukin-6 with coronary artery disease. The aim of this study is to investigate the relationship between IL-6 gene polymorphisms and coronary artery disease. Methods This study was conducted as a meta-analysis of selected articles with no lower time limit and upto March 2020. Articles related to the subject were obtained by searching several data sources,such as the SID, IranDoc, Scopus, Embase, Web of Science (ISI), PubMed, Science Direct, and Google Scholar databases. The heterogeneity of the studies was assessed using the I2 index in the Comprehensive Meta-Analysis software. Results The GG genotype of the IL-6174 G> C polymorphism with a 0.8 odds ratio tended to reduce the risk of CAD by 20%. The odds ratio of CAD in CG and GG genotypes were found to be 1.16 and 1.48 times respectively, indicating the increasing effect of these two genotypes. In the IL-6-572 C>G polymorphism, CG and GG genotypes increased the risk of CAD by 1.21 and 1.27 times respectively, and the CC genotype tended to reduce the risk of CAD by 15%, considering the odds ratio of 0.85. Conclusion This study showed a relationship between IL-6174G> C and Interleukin-6 (IL-6) 572 C>G genes and coronary artery disease. Moreover, the protective effects of GG genotype in IL-6 gene 174 G> C and CC genotype in IL-6 gene 572 C>G gene were reported. The study also confirmed that the CG and CC genotypes of the G>C IL-6174 gene have an increasing effect on coronary artery disease. Moreover, CG and GG genotypes in the IL-6 gene 572 C>G increased the risk of developing CAD. It should be noted that the increased risk of developing CAD was limited to meta-analytic studies in reported literatures.

scholarly journals The association of apolipoprotein-E (APOE) gene polymorphisms with coronary artery disease: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sana Ashiq ◽  
Kanwal Ashiq
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Apolipoprotein E ◽  
Odds Ratio ◽  
English Language ◽  
Meta Analysis ◽  
Final Analysis ◽  
Ε4 Allele ◽  
Artery Disease

Abstract Background Numerous studies have investigated the role of apolipoprotein E (APOE) polymorphisms in coronary artery disease (CAD), but some controversies exist regarding the outcomes as the results were not consistent and remain uncertain. Therefore, the present meta-analysis was conducted to evaluate the association of APOE polymorphisms with coronary artery disease. Methods All the relevant studies published in English language till August 2020 were identified by searching through various electronic databases. The complete data was independently extracted by the two researchers. The data were analyzed by using the Comprehensive Meta-Analysis program and MetaGenyo program. The pooled odds ratio was used to check the associations between CAD and APOE polymorphisms. The following genetic models were used to calculate the odds ratio: ε2 vs. ε3 and ε4 vs. ε3. Results In the final analysis, we include 12 studies regarding the role of APOE polymorphism in CAD. The pooled odds ratio for ε4 allele was higher (OR 2.00; 95% and CI, 1.48–2.71). There is no statistical significant association for ε2 allele with CAD (OR 1.38; 95% CI, 1.18–1.62). This analysis showed no publication bias exists in the current meta-analysis. Conclusions Our findings suggest that the apolipoprotein ε4 allele appears as a significant genetic risk factor for coronary artery disease while the ε2 allele is beneficial to alleviate the CAD risk. Trial registration Registered with PROSPERO International Prospective Register of Systematic Reviews. PROSPERO registration number CRD42020190464

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