scholarly journals The predictive value of lymphocyte-to-monocyte ratio in the prognosis of acute coronary syndrome patients: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Xiao-Qing Quan ◽  
Run-Chang Wang ◽  
Qing Zhang ◽  
Cun-Tai Zhang ◽  
Lei Sun
Keyword(s):  
Systematic Review ◽  
Acute Coronary Syndrome ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Cochrane Library ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Lymphocyte To Monocyte Ratio ◽  
Long Term Mortality

Abstract Background: The association between the lymphocyte-to-monocyte ratio (LMR) and prognosis in the patients with acute coronary syndrome (ACS) is not fully understood. We performed this systematic review and meta-analysis to evaluate the correlation between LMR and mortality or major adverse cardiac events (MACE) in patients with ACS. Methods: A systematic search was performed in MEDLINE, Web of science, EMBASE, Scopus, and the Cochrane Library. The association between LMR and mortality/MACE was analyzed in patients with ACS. The search was updated to April 15, 2020. Results: A total of 5 studies comprising 4343 patients were included in this meta-analysis. The results showed that lower LMR predicted higher short-term mortality/MACE (hazard ratio [HR] = 3.44, 95% confidence interval [CI]: 1.46–8.14, P < 0.05) and long-term mortality/MACE (HR = 1.70, 95% CI: 1.36– 2.13, P < 0.05). In the subgroup analysis, there was still statistical significance of long-term mortality/MACE in all subgroups. Conclusions: This study suggested that lower LMR value might be associated with poor prognosis in ACS patients.

scholarly journals The predictive value of lymphocyte-to-monocyte ratio in the prognosis of acute coronary syndrome patients: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Xiao-Qing Quan ◽  
Run-Chang Wang ◽  
Qing Zhang ◽  
Cun-Tai Zhang ◽  
Lei Sun
Keyword(s):  
Systematic Review ◽  
Acute Coronary Syndrome ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Cochrane Library ◽  
Short Term ◽  
Coronary Syndrome ◽  
Lymphocyte To Monocyte Ratio ◽  
Long Term Mortality

Abstract Background: The association between the lymphocyte-to-monocyte ratio (LMR) and prognosis in the patients with acute coronary syndrome (ACS) is not fully understood. We performed this systematic review and meta-analysis to evaluate the correlation between LMR and mortality or major adverse cardiac events (MACE) in patients with ACS.Methods: A systematic search was performed in PubMed, MEDLINE, EMBASE, the Cochrane Library, Scopus, and Web of science. The association between LMR and mortality/MACE was analyzed in patients with ACS. The search was updated to April 15, 2020. Results: A total of 5 studies comprising 4343 patients were included in this meta-analysis. The results showed that lower LMR predicted higher short-term mortality/MACE (hazard ratio [HR] = 3.44, 95% confidence interval [CI]: 1.46–8.14, P < 0.05) and long-term mortality/MACE (HR = 1.70, 95% CI: 1.36– 2.13, P < 0.05). In the subgroup analysis, there was still statistical significance of long-term mortality/MACE in all subgroups.Conclusions: This study suggested that lower LMR value might be associated with higher short-term and long-term mortality/MACE in ACS patients. Especially for younger ACS patients, low LMR was more closely associated with poor prognosis.

scholarly journals The predictive value of lymphocyte-to-monocyte ratio in the prognosis of acute coronary syndrome patients: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Xiao-Qing Quan ◽  
Run-Chang Wang ◽  
Qing Zhang ◽  
Cun-Tai Zhang ◽  
Lei Sun
Keyword(s):  
Systematic Review ◽  
Acute Coronary Syndrome ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Short Term ◽  
Coronary Syndrome ◽  
Lymphocyte To Monocyte Ratio ◽  
Short Term Mortality ◽  
Long Term Mortality

Abstract Background: The association between the lymphocyte-to-monocyte ratio (LMR) and prognosis of patients with acute coronary syndrome (ACS) is not fully understood. We performed this systematic review and meta-analysis to evaluate the correlation between LMR and mortality or major adverse cardiac events (MACE) in patients with ACS. Methods: A systematic search was performed in PubMed, MEDLINE, EMBASE, the Cochrane Library, Scopus and Web of science. The association between LMR and mortality or MACE was analyzed in patients with ACS. The search was updated to April 15, 2020. Results: A total of 5 studies comprising 4343 patients were included in this meta-analysis. The results showed that lower LMR predicted short-term mortality/MACE (hazard ratio [HR] = 3.44, 95% confidence interval [CI]: 1.46–8.14, P < 0.05) and higher long-term mortality/MACE (HR = 1.70, 95% CI: 1.36– 2.13, P < 0.05). According to our subgroup analysis, there is still has a statistical significance for LMR to predict long-term mortality/MACE in any subgroups. Conclusions: This study suggested that lower LMR value might be associated with higher short-term mortality/MACE and long-term mortality/MACE in ACS patients. Especially for younger ACS patients, low LMR was more closely associated with poor prognosis.

scholarly journals The predictive value of lymphocyte-to-monocyte ratio in the prognosis of acute coronary syndrome patients: A systematic review and meta-analysis

2019 ◽  
Author(s):  
Run-Chang Wang ◽  
Qing Zhang ◽  
Cun-Tai Zhang ◽  
Lei Sun ◽  
Xiao-Qing Quan
Keyword(s):  
Systematic Review ◽  
Acute Coronary Syndrome ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Short Term ◽  
Coronary Syndrome ◽  
Lymphocyte To Monocyte Ratio ◽  
Short Term Mortality ◽  
Long Term Mortality

Abstract The association between the lymphocyte-to-monocyte ratio (LMR) and prognosis of patients with acute coronary syndrome (ACS) is not fully understood. We performed this systematic review and meta-analysis to evaluate the correlation between LMR and mortality or major adverse cardiac events (MACE) in patients with ACS.Methods A systematic search was performed in PubMed, MEDLINE, EMBASE, the Cochrane Library, Scopus and Web of science. The association between LMR and mortality or MACE was analyzed in patients with ACS. The search was updated to August 1, 2019.Results A total of 5 studies comprising 3122 patients were included in this meta-analysis. The results showed that lower LMR predicted short-term mortality/MACE (odds ratio [OR] = 2.61, 95% confidence interval [CI]: 1.15–5.94, P = 0.022) and higher long-term mortality/MACE (OR = 2.10, 95% CI: 1.06–4.19, P = 0.035). According to our subgroup analysis, there still has a statistical significance for LMR predict short-term mortality/MACE in lager sample size researches (≥600, OR = 3.50, 95% CI: 1.84–6.67, p < 0.001),Turkey researches (OR = 4.16, 95% CI: 2.32–7.46, p < 0.001), younger patients researches (< 62, OR = 3.76, 95% CI: 2.29–6.18, p < 0.001).Conclusions This study suggested that lower LMR value might be associated with higher short-term mortality/MACE and long-term mortality/MACE in patients with ACS.

Prehospital tele-electrocardiographic triage improves the management of acute coronary syndrome in rural populations: A systematic review and meta-analysis

2020 ◽  
pp. 1357633X2096062
Author(s):  
Gilbert Lazarus ◽  
HL Kirchner ◽  
Bambang B Siswanto
Keyword(s):  
Acute Coronary Syndrome ◽  
Hospital Mortality ◽  
Rural Areas ◽  
Emergency Services ◽  
Meta Analysis ◽  
Coronary Syndrome ◽  
Evidence Quality ◽  
Poor Outcomes ◽  
Long Term Mortality

Introduction Acute coronary syndrome (ACS) patients residing in rural areas are predisposed to higher risk of poor outcomes due to substantial delays in disease management, emphasising the importance of emerging telecardiology technologies in delivering emergency services in such settings. This meta-analysis aimed to investigate the impacts of prehospital telecardiology strategies on the clinical outcomes of rural ACS patients. Methods A literature search was performed of articles published up to April 2020 through six databases. Included studies were assessed for bias risk using the ROBINS-I tool, and a random-effects model was utilised to estimate effect sizes. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results Twelve studies with a total of 3989 patients were included in this review. Prehospital telecardiology in the form of tele-electrocardiography (tele-ECG) enabled prompt diagnosis and triage, resulting in a decreased door-to-balloon (DTB) time (mean difference = –25.53 minutes, 95% confidence interval (CI) –36.08 to –14.97 minutes; I2 = 98%), as well as lower in-hospital mortality (odds ratio (OR) = 0.57, 95% CI 0.36–0.92) and long-term mortality (OR = 0.52, 95% CI 0.39–0.69) rates, both with negligible heterogeneity ( I2 = 0%). GRADE assessment yielded very low to moderate certainty of evidence. Conclusion Prehospital tele-ECG appeared to be an effective and worthwhile approach in the management of rural ACS patients, as shown by moderate quality evidence on lower long-term mortality. Given the uncertainties of the evidence quality on DTB time and in-hospital mortality, future studies with a higher quality of evidence are required to confirm our findings.

scholarly journals Is hydroxychloroquine with macrolide a good combination in COVID-19 compared to hydroxychloroquine alone from cardiac perspective? A systematic review and meta-analysis

2020 ◽  
Author(s):  
Sitaram Khadka ◽  
Pravash Budhathoki ◽  
Dhan Bahadur Shrestha ◽  
Era Rawal
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Cochrane Library ◽  
Cardiac Events ◽  
Level Of Evidence ◽  
Risk Of Mortality ◽  
Adverse Cardiac Events ◽  
Fixed And Random Effects ◽  
Quantitative Synthesis

Abstract Background: The global spread of COVID-19 and the lack of definite treatment has caused an alarming crisis in the world. Hydroxychloroquine (HCQ) and azithromycin (AZT) are considered a possible treatment option. We aimed to evaluate the outcome and potential harmful cardiac effects of AZT+HCQ compared to HCQ alone for COVID-19 treatment.Methods: Pubmed, Medline, Google Scholar, Cochrane Library, and clinicaltrials.gov were searched using appropriate keywords and identified six studies using PRISMA guidelines. The quantitative synthesis was performed using fixed and random effects for the pooling of studies. Result: In this systematic review and meta-analysis, the risk of mortality (RR 1.16; 0.92-1.46) and adverse cardiac events (OR 1.06; 0.82-1.37) demonstrated a small increment though of no significance. There are no increased odds of mechanical ventilation (OR 0.84; 0.33-2.15) and significant QTc prolongation (OR 0.84, 0.59-1.21). Neither the critical QTc threshold (OR 1.92, CI 0.81-4.56) nor absolute ΔQTc ≥60ms (OR 1.95, CI 0.55-6.96) is increased to the level of statistical significance among HCQ+AZT arm compared to HCQ alone; but its slightly increased odds need to be considered in clinical practice. Conclusion: The combination of AZT+HCQ leads to small increased odds of mortality and cardiac events compared to HCQ alone. It is of no statistical significance for the critical QTc threshold and absolute ΔQTc ≥60ms, but increased odds with HCQ+AZT arm need to be considered in clinical relevance. Our result does not guide against the use of combination or HCQ alone based on the present level of evidence.

scholarly journals Corticosteroids for Treating Sepsis in Adult Patients: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Huoyan Liang ◽  
Heng Song ◽  
Ruiqing Zhai ◽  
Gaofei Song ◽  
Hongyi Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Evaluation Methodology ◽  
Cochrane Library ◽  
Assessment Development ◽  
Short Time ◽  
Long Term Mortality

ObjectiveCorticosteroids are a common option used in sepsis treatment. However, the efficacy and potential risk of corticosteroids in septic patients have not been well assessed. This review was performed to assess the efficacy and safety of corticosteroids in patients with sepsis.MethodsPubMed, Embase, and Cochrane library databases were searched from inception to March 2021. Randomized controlled trials (RCTs) that evaluated the effect of corticosteroids on patients with sepsis were included. The quality of outcomes in the included articles was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation methodology. The data were pooled by using risk ratio (RR) and mean difference (MD). The random-effects model was used to evaluate the pooled MD or RR and 95% confidence intervals (CIs).ResultsFifty RCTs that included 12,304 patients with sepsis were identified. Corticosteroids were not associated with the mortality in 28-day (RR, 0.94; 95% CI, 0.87–1.02; evidence rank, moderate) and long-term mortality (&gt;60 days) (RR, 0.96; 95% CI, 0.88–1.05) in patients with sepsis (evidence rank, low). However, corticosteroids may exert a significant effect on the mortality in the intensive care unit (ICU) (RR, 0.9; 95% CI, 0.83–0.97), in-hospital (RR, 0.9; 95% CI, 0.82–0.99; evidence rank, moderate) in patients with sepsis or septic shock (evidence rank, low). Furthermore, corticosteroids probably achieved a tiny reduction in the length of hospital stay and ICU. Corticosteroids were associated with a higher risk of hypernatremia and hyperglycemia; furthermore, they appear to have no significant effect on superinfection and gastroduodenal bleeding.ConclusionsCorticosteroids had no significant effect on the 28-day and long-term mortality; however, they decreased the ICU and hospital mortality. The findings suggest that the clinical corticosteroids may be an effective therapy for patients with sepsis during the short time.Systematic Review Registrationhttps://inplasy.com/wp-content/uploads/2021/05/INPLASY-Protocol-1074-4.pdf

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