Pulmonary rehabilitation and cardiovascular risk in COPD: a systematic review

AbstractThe aims of this systematic review and meta-analysis were to describe prevalence of cardiovascular disease in gout, compare these results with non-gout controls and consider whether there were differences according to geography. PubMed, Scopus and Web of Science were systematically searched for studies reporting prevalence of any cardiovascular disease in a gout population. Studies with non-representative sampling, where a cohort had been used in another study, small sample size (< 100) and where gout could not be distinguished from other rheumatic conditions were excluded, as were reviews, editorials and comments. Where possible meta-analysis was performed using random-effect models. Twenty-six studies comprising 949,773 gout patients were included in the review. Pooled prevalence estimates were calculated for five cardiovascular diseases: myocardial infarction (2.8%; 95% confidence interval (CI)s 1.6, 5.0), heart failure (8.7%; 95% CI 2.9, 23.8), venous thromboembolism (2.1%; 95% CI 1.2, 3.4), cerebrovascular accident (4.3%; 95% CI 1.8, 9.7) and hypertension (63.9%; 95% CI 24.5, 90.6). Sixteen studies reported comparisons with non-gout controls, illustrating an increased risk in the gout group across all cardiovascular diseases. There were no identifiable reliable patterns when analysing the results by country. Cardiovascular diseases are more prevalent in patients with gout and should prompt vigilance from clinicians to the need to assess and stratify cardiovascular risk. Future research is needed to investigate the link between gout, hyperuricaemia and increased cardiovascular risk and also to establish a more thorough picture of prevalence for less common cardiovascular diseases.

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Safety and efficacy of inpatient pulmonary rehabilitation for patients hospitalised with an acute exacerbation of chronic obstructive pulmonary disease: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2020-043377 ◽

2021 ◽

Vol 11 (6) ◽

pp. e043377

Author(s):

Kai Zhu ◽

Jagdeep Gill ◽

Ashley Kirkham ◽

Joel Chen ◽

Amy Ellis ◽

...

Keyword(s):

Systematic Review ◽

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Acute Exacerbation ◽

Pulmonary Rehabilitation ◽

Meta Analysis ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Safety And Efficacy

IntroductionPulmonary rehabilitation (PR) following an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) reduces the risk of hospital admissions, and improves physical function and health-related quality of life. However, the safety and efficacy of in-hospital PR during the most acute phase of an AECOPD is not well established. This paper describes the protocol for a systematic review with meta-analysis to determine the safety and efficacy of inpatient acute care PR during the hospitalisation phase.Methods and analysisMedical literature databases and registries MEDLINE, EMBASE, Physiotherapy Evidence Database, Cumulative Index to Nursing and Allied Health Literature, Canadian Agency for Drugs and Technologies in Health, CENTRAL, Allied and Complementary Medicine Database, WHO trials portal and ClinicalTrials.gov will be searched for articles from inception to June 2021 using a prespecified search strategy. We will identify randomised controlled trials that have a comparison of in-hospital PR with usual care. PR programmes had to commence during the hospitalisation and include a minimum of two sessions. Title and abstract followed by full-text screening will be conducted independently by two reviewers. A meta-analysis will be performed if there is sufficient homogeneity across selected studies or groups of studies. The Population, Intervention, Comparator, Outcomes and Study characteristics framework will be used to standardise the data collection process. The quality of the cumulative evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations framework.Ethics and disseminationAECOPD results in physical limitations which are amenable to PR. This review will assess the safety and efficacy of in-hospital PR for AECOPD. The results will be presented in a peer-reviewed publication and at research conferences. Ethical review is not required for this study.

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The neurological level of spinal cord injury and cardiovascular risk factors: a systematic review and meta-analysis

Spinal Cord ◽

10.1038/s41393-021-00678-6 ◽

2021 ◽

Author(s):

Peter Francis Raguindin ◽

Gion Fränkl ◽

Oche Adam Itodo ◽

Alessandro Bertolo ◽

Ramona Maria Zeh ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Blood Pressure ◽

Spinal Cord ◽

Cardiovascular Risk ◽

Meta Analysis ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Low Density ◽

Cord Injury

Abstract Study design Systematic review and meta-analysis. Objective To determine the difference in cardiovascular risk factors (blood pressure, lipid profile, and markers of glucose metabolism and inflammation) according to the neurological level of spinal cord injury (SCI). Methods We searched 5 electronic databases from inception until July 4, 2020. Data were extracted by two independent reviewers using a pre-defined data collection form. The pooled effect estimate was computed using random-effects models, and heterogeneity was calculated using I2 statistic and chi-squared test (CRD42020166162). Results We screened 4863 abstracts, of which 47 studies with 3878 participants (3280 males, 526 females, 72 sex unknown) were included in the meta-analysis. Compared to paraplegia, individuals with tetraplegia had lower systolic and diastolic blood pressure (unadjusted weighted mean difference, −14.5 mmHg, 95% CI −19.2, −9.9; −7.0 mmHg 95% CI −9.2, −4.8, respectively), lower triglycerides (−10.9 mg/dL, 95% CI −19.7, −2.1), total cholesterol (−9.9 mg/dL, 95% CI −14.5, −5.4), high-density lipoprotein (−1.7 mg/dL, 95% CI −3.3, −0.2) and low-density lipoprotein (−5.8 mg/dL, 95% CI −9.0, −2.5). Comparing individuals with high- vs. low-thoracic SCI, persons with higher injury had lower systolic and diastolic blood pressure (−10.3 mmHg, 95% CI −13.4, −7.1; −5.3 mmHg 95% CI −7.5, −3.2, respectively), while no differences were found for low-density lipoprotein, serum glucose, insulin, and inflammation markers. High heterogeneity was partially explained by age, prevalent cardiovascular diseases and medication use, body mass index, sample size, and quality of studies. Conclusion In SCI individuals, the level of injury may be an additional non-modifiable cardiovascular risk factor. Future well-designed longitudinal studies with sufficient follow-up and providing sex-stratified analyses should confirm our findings and explore the role of SCI level in cardiovascular health and overall prognosis and survival.

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Conventional cardiovascular risk factors in Transient Global Amnesia: Systematic review and proposition of a novel hypothesis

Frontiers in Neuroendocrinology ◽

10.1016/j.yfrne.2021.100909 ◽

2021 ◽

Vol 61 ◽

pp. 100909

Author(s):

Ioannis Liampas ◽

Maria Raptopoulou ◽

Vasileios Siokas ◽

Christos Bakirtzis ◽

Zisis Tsouris ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Transient Global Amnesia ◽

Global Amnesia

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A systematic review on the association between total and cardiopulmonary mortality/morbidity or cardiovascular risk factors with long-term exposure to increased or decreased ambient temperature

The Science of The Total Environment ◽

10.1016/j.scitotenv.2021.145383 ◽

2021 ◽

Vol 772 ◽

pp. 145383

Author(s):

Sofia Zafeiratou ◽

Evangelia Samoli ◽

Konstantina Dimakopoulou ◽

Sophia Rodopoulou ◽

Antonis Analitis ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Cardiovascular Risk ◽

Ambient Temperature ◽

Cardiovascular Risk Factors

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Probiotic supplementation for management of cardiovascular risk factors in adults with type II diabetes: A systematic review and meta-analysis

Clinical Nutrition ◽

10.1016/j.clnu.2017.02.015 ◽

2018 ◽

Vol 37 (2) ◽

pp. 532-541 ◽

Cited By ~ 42

Author(s):

Fatemeh Hendijani ◽

Vajihe Akbari

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Type Ii Diabetes ◽

Meta Analysis ◽

Type Ii ◽

Probiotic Supplementation

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Short-term Efficacy of Upper-Extremity Exercise Training in Patients With Chronic Airway Obstruction: A Systematic Review

Physical Therapy ◽

10.2522/ptj.20070368 ◽

2009 ◽

Vol 89 (5) ◽

pp. 443-455 ◽

Cited By ~ 18

Author(s):

Stefania Costi ◽

Mauro Di Bari ◽

Paolo Pillastrini ◽

Roberto D'Amico ◽

Ernesto Crisafulli ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Exercise Training ◽

Pulmonary Rehabilitation ◽

Health Related Quality ◽

Inclusion Criteria ◽

Patient Centered ◽

Related Quality ◽

Health Related

Background, Objectives, and Measurements Patients with chronic airway obstruction (CAO) frequently experience dyspnea and fatigue during activities performed by accessory muscles of ventilation, which competitively participate in arm elevation. This systematic review of randomized controlled trials (RCTs) concerning patients with CAO addresses the effects of upper-extremity exercise training (UEET), added to lower-extremity training or comprehensive pulmonary rehabilitation, on the following patient-centered outcomes: exercise capacity, symptoms, ability to perform daily activities, and health-related quality of life. Methods Studies were retrieved using comprehensive database and hand-search strategies. Two independent reviewers determined study eligibility based on inclusion criteria. A detailed description of treatments was mandatory. Reviewers rated study quality and extracted information on study methods, design, intervention, and results. Results Forty publications were evaluated. Four RCTs met the inclusion criteria but had serious methodological limitations, which introduce possible biases that reduce their internal validity. The outcomes measured were heterogeneous, and the results were inconsistent regarding maximal exercise capacity, dyspnea, and health-related quality of life. No effect of UEET was demonstrated for measures of arm fatigue. Limitations and Conclusions The limited methodological quality of the studies retrieved prevented us from performing a meta-analysis, the results of which could be misleading. This systematic review shows that there is limited evidence examining UEET and that the evidence available is of poor quality. Therefore, a recommendation for the inclusion or exclusion of UEET in pulmonary rehabilitation programs for individuals with CAO is not possible. Further research is needed to definitively ascertain the effects of this training modality on patient-centered outcomes.

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