scholarly journals The Efficacy of Fish Oil in Preventing Coronary Heart Disease: A Systematic Review and Meta-Analysis

Author(s):  
Gaohong Wu ◽  
Haifeng Geng ◽  
Yue Jiang ◽  
Wei Song ◽  
Xueping Zhu ◽  
...  

To evaluate the efficacy of fish oil for protection against coronary heart disease (CHD), we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating the use of fish oil for protection against CHD. We retrieved relevant articles published from January 1966 to January 2020 by searching the PubMed, EMBASE, Cochrane CENTRAL, and Web of Science databases. RCTs of fish oil in preventing CHD were selected. The study quality was evaluated using the Cochrane Risk of Bias tool with RevMan 5.3 software. The first selection involved 350 citations. After screening and evaluation of suitability, 19 RCTs adjusted for clustering were included in the meta-analysis. All selected manuscripts considered that fish oil was effective in preventing CHD, secondary outcome measures included angina, sepsis and death. Compared with the control group, fish oil may confer significant protection against CHD (odds ratio = 0.84; 95% confidence interval: 0.72–0.98). There was no significant difference in the incidence of secondary outcomes between the observation group and the control group (P > 0.05). The above results show that fish oil plays an important role in reducing CHD and cardiovascular events. However, because of the suboptimal quality of the studies included into the meta-analysis, these results do not justify adding fish oils systematically to the heavy pharmaceutical assortment already recommended in CHD patients.

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 585
Author(s):  
Lee Sandwith ◽  
Patrice Forget

Background and Objectives: In this paper, we investigated the efficacy of statin therapy on cardiovascular disease (CVD) reduction in adults with no known underlying health conditions by undertaking a meta-analysis and systematic review of the current evidence. Materials and Methods: We performed a systematic search to identify Primary Prevention Randomized Controlled Trials (RCTs) that compared statins with a control group where CVD events or mortality were the primary end point. Identified RCTs were evaluated and classified into categories depending on relevance in order to determine which type of meta-analysis would be feasible. Results: No differences were observed between categories with the exception of relative risk for all CVD events combined which showed a 12% statistically significant difference favouring studies which were known to include participants without underlying health conditions. Strong negative correlations between number-need-to-treat (NNT) and LDL-C reduction were observed for all Coronary Heart Disease (CHD) outcomes combined and all CVD outcomes combined. Conclusions: This project highlights the need for further research on the effects of statins on participants who do not suffer from underlying health conditions, given that no such studies have been conducted.


2021 ◽  
Vol 8 (10) ◽  
pp. 123
Author(s):  
Mohammed Ahmed Akkaif ◽  
Abubakar Sha’aban ◽  
Nur Aizati Athirah Daud ◽  
Ismaeel Yunusa ◽  
Mei Li Ng ◽  
...  

Background: A new generation P2Y12 receptor inhibitor (ticagrelor) is recommended in current therapeutic guidelines to treat patients with coronary heart disease (CHD). However, it is unknown if ticagrelor is more effective than clopidogrel in elderly patients. Therefore, a systematic review was done to assess the effectiveness and safety of ticagrelor and clopidogrel in older patients with CHD to determine the appropriate antiplatelet treatment plan. Methodology: We performed a systematic review of randomized controlled trials (RCTs) to compare the effectiveness and safety of ticagrelor vs. clopidogrel in elderly patients with CHD. We selected eligible RCTs based on specified study criteria following a systematic search of PubMed and Scopus databases from January 2007 to May 2021. Primary efficacy outcomes assessed were major adverse cardiovascular events (MACEs), myocardial infarction (MI), stent thrombosis (ST), and all-cause death. The secondary outcome assessed was major bleeding events. We used RevMan 5.3 software to conduct a random-effects meta-analysis and estimated the pooled incidence and risk ratios (RRs) with 95% confidence intervals (CIs) for ticagrelor and clopidogrel. Results: Data from 6 RCTs comprising 21,827 elderly patients were extracted according to the eligibility criteria. There was no significant difference in the MACE outcome (incidence: 9.23% vs. 10.57%; RR = 0.95, 95% CI = 0.70–1.28, p = 0.72), MI (incidence: 5.40% vs. 6.23%; RR = 0.94, 95% CI= 0.69–1.27, p = 0.67), ST (incidence: 2.33% vs. 3.17%; RR = 0.61, 95% CI= 0.32–1.17, p = 0.13), and all-cause death (4.29% vs. 5.33%; RR = 0.86, 95% CI = 0.65–1.12, p = 0.25) for ticagrelor vs. clopidogrel, respectively. In addition, ticagrelor was not associated with a significant increase in the rate of major bleeding (incidence: 9.98% vs. 9.33%: RR = 1.37, 95% CI = 0.97–1.94, p = 0.07) vs. clopidogrel. Conclusions: This study did not find evidence that ticagrelor is significantly more effective or safer than clopidogrel in elderly patients with CHD.


2020 ◽  
Author(s):  
Yu-Xin Chen ◽  
Pei Zhao ◽  
ZhuLiduzi Jiesisibieke ◽  
Pei-En Chen ◽  
Tao-Hsin Tung ◽  
...  

Abstract Background: To assess the relationship between delivery mode and postpartum depression and to examine whether cesarean section (CS) has a higher risk of postpartum depression than vaginal delivery (VD). Methods: We searched the Cochrane Library, PubMed, and EMBASE from inception to 30 April 2019 without language limitations. Two authors independently selected studies, assessed the quality of included studies, and extracted data. Any disagreements were resolved by discussion with a third author. We used the Newcastle-Ottawa Scale and GRADE methods to assess the quality of the included studies and evidences. This study had four included cohort studies data and carried out fixed-effect model meta-analysis. Results: The findings demonstrated a significant difference in the risk of postpartum depression between CS and VD. Compared with the control group, the CS group was associated with a higher prevalence of postpartum depression symptoms (Risk Ratio =1.29; 95% CI: 1.11-1.51). Conclusions: The findings supported a relationship between delivery mode and postpartum depression. Particularly, we found that CS is associated with a higher risk of postpartum depression. Therefore, we ought to encourage pregnant women who are without medical indication of CS to select VD.r Trial registration: The protocol of this systematic review was registered in the PROSPERO under the number CRD42019148154.


BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e021070 ◽  
Author(s):  
Seoyoun Kim ◽  
Sook-Hyun Lee ◽  
Me-Riong Kim ◽  
Eun-Jung Kim ◽  
Deok-Sang Hwang ◽  
...  

ObjectivesNeck pain is a significant condition that is second only to depression as a cause of years lived with disability worldwide. Thus, identifying and understanding effective treatment modalities for neck pain is of heightened importance. This systematic review aimed to investigate the effects of cupping on neck pain from the current literature.DesignSystematic review and meta-analysis of randomised controlled trials (RCTs).SettingNine databases, including Chinese, Korean and Japanese databases, were searched for data up to January 2018 with no restrictions on publication language.ParticipantsPatients with neck pain.InterventionsCupping therapy as the sole or add-on intervention compared with no treatment or active controls.Primary and secondary outcome measuresPain severity, functional disability and quality of life.ResultsEighteen RCTs were selected. Compared with the no intervention group, the cupping group exhibited significant reduction in pain (mean difference (MD) −2.42(95% CI −3.98 to −0.86)) and improvement in function (MD −4.34(95% CI −6.77 to −1.19)). Compared with the active control, the cupping group reported significant reduction in pain (p=0.0009) and significantly improved quality of life (p=0.001). The group that received control treatment with cupping therapy (add-on group) displayed significant pain reduction compared with the active control group (p=0.001). Of the 18 studies, only 8 reported occurrence of adverse events, which were mostly mild and temporary.ConclusionsCupping was found to reduce neck pain in patients compared with no intervention or active control groups, or as an add-on treatment. Depending on the type of control group, cupping was also associated with significant improvement in terms of function and quality of life; however, due to the low quality of evidence of the included studies, definitive conclusions could not be drawn from this review. Future well-designed studies are needed to substantiate the effectiveness of cupping on neck pain.PROSPERO registration numberCRD42016047218.


2020 ◽  
Author(s):  
Yu-Xin Chen ◽  
Pei Zhao ◽  
Zhu Liduzi Jiesisibieke ◽  
Pei-En Chen ◽  
Tao-Hsin Tung ◽  
...  

Abstract Background To assess the relationship between delivery mode and postpartum depression and to examine whether cesarean section (CS) has a higher risk of postpartum depression than vaginal delivery (VD). Methods We searched the Cochrane Library, PubMed, and EMBASE from inception to 30 April 2019 without language limitations. Then two authors independently selected the studies, assessed the quality of the included studies, and extracted data. Any disagreements were resolved by discussion with a third author. Next, we used the Newcastle-Ottawa Scale and GRADE methods are used to evaluate the quality of the included studies and evidences, respectively. This study had four included cohort studies data and carried out fixed-effect model meta-analysis. Results The findings demonstrated a significant difference in the risk of postpartum depression between CS and VD. Compared with the control group, the CS group was associated with a higher prevalence of postpartum depression symptoms (Risk Ratio = 1.29; 95% CI: 1.11–1.51). Conclusions The results showed that delivery mode has nonnegligible effects on the risk of postpartum depression. Particularly, we found that CS is associated with a higher risk of postpartum depression compared with VD. Therefore, we ought to encourage pregnant women who are without medical indication of CS to select VD. Trial registration: The protocol of this systematic review was registered in PROSPERO under the number CRD42019148154.


2016 ◽  
Vol 29 (8) ◽  
pp. 1308-1349 ◽  
Author(s):  
Kate Laver ◽  
Rachel Milte ◽  
Suzanne Dyer ◽  
Maria Crotty

Objective: The aim of this study was to compare the efficacy of two approaches: multicomponent interventions that focus on working with the carer and dyadic interventions that work with both the carer and the person with dementia. Method: A systematic review involving a search of Medline, EMBASE, and PsycINFO in October 2015 was performed. Randomized controlled trials involving carers of people with dementia and comparing multicomponent interventions with usual care were included. Results: Pooling of all studies demonstrated that multicomponent interventions can reduce depressive symptoms, improve quality of life, reduce carer impact, and reduce behavioral and psychological symptoms of dementia as well as caregiver upset with these symptoms. We were unable to find a significant difference in the effects of dyadic interventions in comparison with carer focused interventions for these outcomes. Discussion: Although effect sizes associated with intervention are small, multicomponent interventions are relatively inexpensive to deliver, acceptable, and widely applicable.


Author(s):  
Kellen A. Knowles ◽  
Helen Xun ◽  
Sunyoung Jang ◽  
Sharon Pang ◽  
Charles Ng ◽  
...  

Background Caregivers provide critical support for patients with chronic diseases, including heart disease, but often experience caregiver stress that negatively impacts their health, quality of life, and patient outcomes. We aimed to inform health care teams on an evidence‐based approach to supporting the caregivers of patients with heart disease. Methods and Results We conducted a systematic review and meta‐analysis of randomized controlled trials written in English that evaluated interventions to support caregivers of patients with heart disease. We identified 15,561 articles as of April 2, 2020 from 6 databases; of which 20 unique randomized controlled trials were evaluated, representing a total of 1570 patients and 1776 caregivers. Most interventions focused on improving quality of life, and reducing burden, depression, and anxiety; 85% (17 of 20) of the randomized controlled trials provided psychoeducation for caregivers. Interventions had mixed results, with moderate non‐significant effects observed for depression (Hedges’ g=−0.64; 95% CI, −1.34 to 0.06) and burden (Hedges’ g=−0.51; 95% CI, −2.71 to 1.70) at 2 to 4 months postintervention and small non‐significant effects observed for quality of life and anxiety. These results were limited by the heterogeneity of outcome measures and intervention delivery methods. A qualitative synthesis of major themes of the interventions resulted in clinical recommendations represented with the acronym “CARE” (Caregiver‐Centered, Active engagement, Reinforcement, Education). Conclusions This systematic review highlights the need for greater understanding of the challenges faced by caregivers and the development of guidelines to help clinicians address those challenges. More research is necessary to develop clinical interventions that consistently improve caregiver outcomes.


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