Abstract P227: Diabetes Mellitus and Venous Thromboembolism: A Systematic Review and Meta-analysis

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Elizabeth J Bell ◽  
Aaron R Folsom ◽  
Pamela L Lutsey ◽  
Elizabeth Selvin ◽  
Mary Cushman ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Venous Thromboembolism ◽  
Observational Studies ◽  
Meta Analysis ◽  
Diabetes Mellitus Type 1 ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Study Heterogeneity ◽  
Control Of Diabetes

Introduction: Reported associations of diabetes with venous thromboembolism (VTE) are inconsistent. We conducted a systematic review and meta-analysis to quantify the association between diabetes mellitus (type 1 or 2) and VTE (deep vein thrombosis or pulmonary embolism). Methods: A systematic review of observational studies was conducted using PubMed, Web of Science, and CINAHL through Dec 31, 2012. Additional studies were identified by contacting experts and through manual review of reference lists of review articles and articles eligible for the present study. We abstracted information on relative risk (RR) estimates and pooled these data using a random-effects model. We queried authors of papers that did not adjust for important confounders to request controlled RR estimates. Results: We identified 10 studies (N participants: 240,940; 7 cohort, 3 case-control: Heit, Lidegaard, and Poulter) which provided RRs adjusted for age and BMI (Figure), and 8 additional studies which did not adjust for these confounders (N participants = 150,205). The pooled RR for the association of diabetes with VTE in the 10 studies was 1.18 (95% CI, 1.03-1.34). The test for heterogeneity was not significant (I 2 = 23.8%, p = 0.22). Amongst the 10 studies, smaller studies tended to have lower RR estimates: Both the Begg and Egger tests were significant (p = 0.02 and 0.01, respectively). The other 8 studies showed evidence of significant between-study heterogeneity (I 2 = 75.5%, p <0.0001), making a pooled estimate inappropriate. Conclusions: Diabetes is associated with an 18% increased risk of VTE in observational studies after accounting for age and obesity. Possible explanations for the association of diabetes with VTE include increased hypercoagulability or vascular damage caused by the metabolic derangements of diabetes or increased exposure to VTE risk factors in individuals with diabetes. Further research is needed to elucidate the mechanisms of this association and whether improved control of diabetes is associated with reduced VTE risk.

scholarly journals Association between progestin-only contraceptive use and cardiometabolic outcomes: A systematic review and meta-analysis

2018 ◽  
Vol 25 (10) ◽  
pp. 1042-1052 ◽  
Author(s):  
Marija Glisic ◽  
Sara Shahzad ◽  
Stergiani Tsoli ◽  
Mahmuda Chadni ◽  
Eralda Asllanaj ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Venous Thromboembolism ◽  
Observational Studies ◽  
Contraceptive Use ◽  
Meta Analysis ◽  
Relative Risks ◽  
Increased Risk ◽  
Stratified Analysis ◽  
The Impact

Aims The association between progestin-only contraceptive (POC) use and the risk of various cardiometabolic outcomes has rarely been studied. We performed a systematic review and meta-analysis to determine the impact of POC use on cardiometabolic outcomes including venous thromboembolism, myocardial infarction, stroke, hypertension and diabetes. Methods and results Nineteen observational studies (seven cohort and 12 case–control) were included in this systematic review. Of those, nine studies reported the risk of venous thromboembolism, six reported the risk of myocardial infarction, six reported the risk of stroke, three reported the risk of hypertension and two studies reported the risk of developing diabetes with POC use. The pooled adjusted relative risks (RRs) for venous thromboembolism, myocardial infarction and stroke for oral POC users versus non-users based on the random effects model were 1.06 (95% confidence interval (CI) 0.70–1.62), 0.98 (95% CI 0.66–1.47) and 1.02 (95% CI 0.72–1.44), respectively. Stratified analysis by route of administration showed that injectable POC with a RR of 2.62 (95% CI 1.74–3.94), but not oral POCs (RR 1.06, 95% CI 0.7–1.62), was associated with an increased risk of venous thromboembolism. A decreased risk of venous thromboembolism in a subgroup of women using an intrauterine levonorgestrel device was observed with a RR of 0.53 (95% CI 0.32–0.89). No effect of POC use on blood pressure was found, but there was an indication for an increased risk of diabetes with injectable POCs, albeit non-significant. Conclusions This systematic review and meta-analysis suggests that oral POC use is not associated with an increased risk of developing various cardiometabolic outcomes, whereas injectable POC use might increase the risk of venous thromboembolism.

scholarly journals Venous thromboembolism in COVID-19: A systematic review and meta-analysis

2021 ◽  
pp. 1358863X2199556
Author(s):  
Anastasios Kollias ◽  
Konstantinos G Kyriakoulis ◽  
Styliani Lagou ◽  
Evangelos Kontopantelis ◽  
George S Stergiou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Venous Thromboembolism ◽  
Meta Analysis ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Study Population ◽  
Meta Regression Analysis ◽  
Thromboembolism Events ◽  
Prophylactic Anticoagulation ◽  
Deep Vein

Severe coronavirus disease 2019 (COVID-19) is associated with increased risk of venous thromboembolism events (VTE). This study performed a systematic review in PubMed/EMBASE of studies reporting the prevalence of VTE in patients with COVID-19 who were totally screened/assessed for deep vein thrombosis (DVT) and/or for pulmonary embolism (PE). Among 47 candidate studies ( n = 6459; 33 in Europe), 17 studies ( n = 3973; weighted age 63.0 years, males 60%, intensive care unit (ICU) 16%) reported the prevalence of PE with a pooled estimate of 32% (95% CI: 25, 40%), and 32 studies ( n = 2552; weighted age 62.6 years, males 57%, ICU 49%) reported the prevalence of DVT with a pooled estimate of 27% (95% CI: 21, 34%). A total of 36 studies reported the use of at least prophylactic antithrombotic treatment in the majority of their patients. Meta-regression analysis showed that the prevalence of VTE was higher across studies with a higher percentage of ICU patients and higher study population mean D-dimer values, and lower in studies with mixed dosing of anticoagulation in ⩾ 50% of the population compared to studies with standard prophylactic dosing of anticoagulation in < 50% of the population. The pooled odds ratio for death in patients with COVID-19 and VTE versus those without VTE (17 studies, n = 2882) was 2.1 (95% CI: 1.2, 3.6). Hospitalized patients with severe COVID-19 are at high VTE risk despite prophylactic anticoagulation. Further research should investigate the individualized VTE risk of patients with COVID-19 and the optimal preventive antithrombotic therapy. PROSPERO Registration No.: CRD42020185543.

scholarly journals TheType 2 Deiodinase Thr92Ala PolymorphismIs Associated with Worse Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Xiaowen Zhang ◽  
Jie Sun ◽  
Wenqing Han ◽  
Yaqiu Jiang ◽  
Shiqiao Peng ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Meta Analysis ◽  
Increased Risk ◽  
Design And Methods ◽  
Hba1c Levels

Objective. Type 2 deiodinase (Dio2) is an enzyme responsible for the conversion of T4 to T3. The Thr92Ala polymorphism has been shown related to an increased risk for developing type 2 diabetes mellitus (T2DM). The aim of this study is to assess the association between this polymorphism and glycemic control in T2DM patients as marked by the HbA1C levels.Design and Methods.The terms “rs225014,” “thr92ala,” “T92A,” or “dio2 a/g” were used to search for eligible studies in the PubMed, Embase, and Cochrane databases and Google Scholar. A systematic review and meta-analysis of studies including both polymorphism testing and glycated hemoglobin (HbA1C) assays were performed.Results. Four studies were selected, totaling 2190 subjects. The pooled mean difference of the studies was 0.48% (95% CI, 0.18–0.77%), indicating that type 2 diabetics homozygous for the Dio2 Thr92Ala polymorphism had higher HbA1C levels.Conclusions. Homozygosity for the Dio2 Thr92Ala polymorphism is associated with higher HbA1C levels in T2DM patients. To confirm this conclusion, more studies of larger populations are needed.

scholarly journals Comparing pharmacological venous thromboembolism prophylaxis to intermittent pneumatic compression in acute intracerebral haemorrhage: protocol for a systematic review and network meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e024405 ◽  
Author(s):  
Vignan Yogendrakumar ◽  
Ronda Lun ◽  
Brian Hutton ◽  
Dean A Fergusson ◽  
Dar Dowlatshahi
Keyword(s):  
Systematic Review ◽  
Venous Thromboembolism ◽  
Intracerebral Haemorrhage ◽  
Meta Analysis ◽  
Indirect Evidence ◽  
Intermittent Pneumatic Compression ◽  
Qualitative Assessment ◽  
Primary Data ◽  
Thromboembolism Prophylaxis ◽  
Increased Risk

IntroductionPatients with an intracerebral haemorrhage are at increased risk of venous thromboembolism. Pharmacotherapy and pneumatic compression devices are capable of preventing venous thromboembolism, however both interventions have limitations. There are no head-to-head comparisons between these two interventions. To address this knowledge gap, we plan to perform a systematic review and network meta-analysis to examine the comparative effectiveness of pharmacological prophylaxis and mechanical compression devices in the context of intracerebral haemorrhage.Methods and analysisMEDLINE, PUBMED, EMBASE, CENTRAL, ClinicalTrials.gov and the Internet Stroke Trials Registry will be searched with assistance from an experienced information specialist. Eligible studies will include those that have enrolled adults presenting with spontaneous intracerebral haemorrhage and compared one or more of the respective interventions against each other and/or a control. Primary outcomes to be assessed are occurrence of new venous thromboembolism (deep vein thrombosis and/or pulmonary embolism) and haematoma expansion, defined as a significant enlargement of baseline haemorrhage or new haemorrhage occurrence. Both randomised and non-randomised comparative studies will be included. Data on participant characteristics, study design, intervention details and outcomes will be extracted. Study quality will be assessed using the Cochrane Risk of Bias Tool and the Robins-I tool. Bayesian network meta-analyses will be performed to compare interventions based on all available direct and indirect evidence. If the transitivity assumption for network meta-analysis cannot be met, we will perform a qualitative assessment.Ethics and disseminationFormal ethics is not required as primary data will not be collected. The findings of this study will be disseminated through conference presentations, and peer-reviewed publications. In an area of clinical practice where equipoise exists, the findings of this study may assist in determining which treatment intervention is most effective in venous thromboembolism prevention.PROSPERO registration numberCRD42018090960.

scholarly journals Association between maternal sleep duration and quality, and the risk of preterm birth: a systematic review and meta-analysis of observational studies

2020 ◽  
Author(s):  
ling wang ◽  
Feng Jin
Keyword(s):  
Systematic Review ◽  
Preterm Birth ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Meta Analysis ◽  
Controlled Study ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Increased Risk ◽  
Study Heterogeneity

Abstract Background : To assess the association of sleep duration and quality with the risk of preterm birth. Methods : Relevant studies were retrieved from the PubMed and Web of Science databases up to September 30, 2018. The reference lists of the retrieved articles were reviewed. Random effects models were applied to estimate summarized relative risks (RRs) and 95% confidence intervals (CIs). Results : Ten identified studies (nine cohort studies and one case-controlled study) examined the associations of sleep duration and quality with the risk of preterm birth. As compared with women with the longest sleep duration, the summary RR was 1.23 (95% CI = 1.01–1.50) for women with the shortest sleep duration, with moderate between-study heterogeneity ( I 2 = 57.4%). Additionally, as compared with women with good sleep quality, the summary RR was 1.54 (95% CI = 1.18–2.01) for women with poor sleep quality (Pittsburgh Sleep Quality Index > 5), with high between-study heterogeneity ( I 2 = 76.7%). Funnel plots as well as the Egger’s and Begg’s tests revealed no evidence of publication bias. Conclusions : This systematic review and meta-analysis revealed that short sleep duration and poor sleep quality may be associated with an increased risk of preterm birth. Further subgroup analyses are warranted to test the robustness of these findings as well as to identify potential sources of heterogeneity.

scholarly journals Pregnancy-related complications and incidence of atrial fibrillation: a systematic review and meta-analysis

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
T Al Bahhawi ◽  
A Aqeeli ◽  
S L Harrison ◽  
D A Lane ◽  
I Buchan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Cohort Studies ◽  
Observational Studies ◽  
Large Scale ◽  
Data Extraction ◽  
Meta Analysis ◽  
Significant Heterogeneity ◽  
Random Effects Models ◽  
Increased Risk

Abstract Funding Acknowledgements Type of funding sources: None. Background Pregnancy-related complications have been previously associated with incident cardiovascular disease. However, data are scarce on the association between pregnancy-related complications and incident atrial fibrillation (AF). This systematic review examines associations between pregnancy-related complications and incident AF. Methods A systematic search of the literature utilising MEDLINE and EMBASE (Ovid) was conducted from 1990 to 6 April 2020. Observational studies examining the association between pregnancy-related complications including hypertensive disorders of pregnancy (HDP), gestational diabetes, placental abruption, preterm birth, low birth weight, small-for-gestational-age and stillbirth, and incidence of AF were included. Screening and data extraction were conducted independently by two reviewers. Inverse-variance random-effects models were used to pool hazard ratios. Results: Six observational studies met the inclusion criteria one case-control study and five retrospective cohort studies, with four studies eligible for meta-analysis.  Sample sizes ranged from 1,839-1,303,365. Mean/median follow-up for the cohort studies ranged from 7-36 years. Most studies reported an increased risk of incident AF associated with pregnancy-related complications. The pooled summary statistic from four studies reflected a greater risk of incident AF for HDP (hazard ratio (HR) 1.47, 95% confidence intervals (CI) 1.18-1.84; I2 = 84%) and from three studies for pre-eclampsia (HR 1.71, 95% CI 1.41-2.06; I2 = 64%; Figure). Conclusions The results of this review suggest that pregnancy-related complications particularly pre-eclampsia appear to be associated with higher risk of incident AF. The small number of included studies and the significant heterogeneity in the pooled results suggest further large-scale prospective studies are required to confirm the association between pregnancy-related complications and AF. Abstract Figure.

scholarly journals Incidence of thromboembolism in patients with COVID-19: a systematic review and meta-analysis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Kochawan Boonyawat ◽  
Pichika Chantrathammachart ◽  
Pawin Numthavaj ◽  
Nithita Nanthatanti ◽  
Sithakom Phusanti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Meta Analysis ◽  
Grey Literature ◽  
Arterial Thromboembolism ◽  
Vein Thrombosis ◽  
Prophylactic Measures ◽  
Compression Ultrasound ◽  
Screening Protocol ◽  
Deep Vein

Abstract Background Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, the incidence of thromboembolism has been increasingly reported. The aim of this systematic review was to explore the incidence of venous and arterial thromboembolism among COVID-19 patients requiring hospitalization. Methods Medline, Embase, Scopus, and grey literature were searched until June 2020. Observational studies reported on the incidence of venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT) or arterial thromboembolism (ATE) were included. The pool incidences and their 95% confidence intervals (CI) were calculated using the random-effects model. Results A total of 36 studies were included. In the intensive care unit (ICU) setting, the pooled incidence of VTE was 28% (95% CI, 22–34%). Subgroups based on compression ultrasound (CUS) screening revealed a higher incidence of DVT in the CUS screening group than in the no CUS screening group (32% [95% CI, 18–45%] vs. 6% [95% CI, 4–9%]). The pooled incidence of ATE in ICU was 3% (95% CI, 2–5%). In the non-ICU setting, the pooled incidence of VTE was 10% (95% CI, 6–14%,). Conclusions The incidence of VTE in COVID-19 patients was higher in the ICU setting than in the non-ICU setting, and also significantly higher in studies that incorporated the CUS screening protocol. The incidence of ATE in the ICU setting was low. VTE prophylactic measures should be given to all hospitalized patients diagnosed with COVID-19.

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