scholarly journals Association of Epicardial Adipose Tissue with Essential Hypertension: A Meta-Analysis

2021 ◽  
Author(s):  
Xinyu Zou ◽  
Yingrui Li ◽  
Qiang She ◽  
Bin Liu
Keyword(s):  
Cardiovascular Disease ◽  
Adipose Tissue ◽  
Essential Hypertension ◽  
Odds Ratio ◽  
Observational Studies ◽  
Epicardial Adipose Tissue ◽  
Meta Analysis ◽  
Hypertensive Patients ◽  
New Information ◽  
Significant Difference

Abstract Background and aims: Increased epicardial adipose tissue (EAT) has been proposed as a risk factor for essential hypertension (EH). The aim of this study was to investigate the association of EAT with EH.Methods and results: PubMed, EMBASE, and Cochrane databases were systematically reviewed to identify relevant studies assessing the association of EAT thickness (EAT-t) and volume (EAT-v) with EH. There were 39 observational studies and 8,983 subjects included in the meta-analysis. The analysis indicated that hypertensive patients had a higher mean of EAT-t (SMD=0.64, 95% CI: 0.44-0.83, p<0.001) and EAT-v (SMD: 0.69, 95% CI:0.34-0.1.05, p<0.001) than normotensive individuals. Accordingly, we calculated pooled odds ratio (OR) and 95% confidence intervals (CI) for the association of EAT with EH, and the results showed that EAT-t (OR: 1.59, 95% CI: 1.09–2.33, P<0.001) and EAT-v (OR: 1.82, 95% CI: 1.33–2.19, P<0.001) were associated with essential hypertension. Additionally, higher mean of EAT-t (SMD=0.85, 95% CI=0.49-0.1.21, p<0.001) and EAT-v (SMD=0.83, 95% CI=0.31-1.34, p=0.002) were found in non-dipper hypertensive patients than those in dipper patients, but we didn’t find significant difference in EAT-t among patients with different grades of hypertension. We also investigated the association of EAT with complications in hypertensive patients, and the results showed that EAT was increased in patients with arteriosclerotic cardiovascular disease (ASCVD) or cardiac hypertrophy and dysfunction than those without. Conclusions: The increase in EAT was associated with the occurrence and complications of EH. The findings provide new information regarding the occurrence and complications of EH.

scholarly journals Role of epicardial adipose tissue in the development of atrial fibrillation in hypertensive patients

2020 ◽  
Vol 19 (6) ◽  
pp. 2707
Author(s):  
V. I. Podzolkov ◽  
A. I. Tarzimanova ◽  
A. E. Bragina ◽  
K. K. Osadchiy ◽  
R. G. Gataulin ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Atrial Fibrillation ◽  
Adipose Tissue ◽  
Odds Ratio ◽  
Multislice Computed Tomography ◽  
Comparison Group ◽  
Epicardial Adipose Tissue ◽  
Hypertensive Patients ◽  
Group I

Obesity is a progressing epidemic, the prevalence of which has doubled over the past 30 years. The distribution of adipose tissue is an important factor in predicting the risk of cardiovascular events. The most significant inflammatory activity is characteristic of epicardial adipose tissue (EAT), the role of which in the development of atrial fibrillation (AF) remains a subject of discussion.Aim. To study the effect of EAT size on the development of AF in hypertensive (HTN) patients.Material and methods. The study included 95 patients with HTN aged 38-72 years (mean age, 61,5±1,8 years), including 45 patients with paroxysmal AF (group I) and 50 patients in the comparison group (group II). In order to assess the severity of visceral obesity, all patients underwent a general examination and echocardiography. To determine the EAT volume, cardiac multislice computed tomography was performed.Results. Echocardiography revealed that the EAT thickness was significantly greater in hypertensive patients with paroxysmal AF than in the comparison group: 11,6±0,8 and 8,6±0,4 mm, respectively (p<0,001). According to cardiac multislice computed tomography, a significant increase in EAT volume was revealed in patients of group I (4,6±0,4 ml) compared with group II (3,5±0,25 ml) (p=0,019). In hypertensive patients with paroxysmal AF, a positive moderate relationship between the EAT volume and left atrial volume was revealed (r=0,7, p=0,022). Multivariate analysis showed that in hypertensive patients, EAT thickness >10 mm and volume >6 ml can serve as integral markers of the onset of paroxysmal AF.Conclusion. Integral markers of AF in hypertensive patients are an increase in the EAT thickness >10 mm (odds ratio, 4,1; 95% confidence interval, 1,1-5,6) and volume >6 ml (odds ratio 3,7; 95%, confidence interval 1,0-4,2).

scholarly journals Epicardial Adipose Tissue Accumulation and Essential Hypertension in Non-Obese Adults

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 456 ◽  
Author(s):  
Austys ◽  
Dobrovolskij ◽  
Jablonskienė ◽  
Dobrovolskij ◽  
Valevičienė ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Essential Hypertension ◽  
Regression Model ◽  
Epicardial Adipose Tissue ◽  
Severe Hypertension ◽  
Resonance Imaging ◽  
Obese Adults ◽  
Hypertensive Patients ◽  
Norm Group ◽  
Artery Disease

Background and Objectives: Epicardial adipose tissue (EAT) is shown to be an important factor in the development of coronary artery disease, but numerous pathophysiological mechanisms of its action are still only partially understood. There is a lack of studies on its association with different grades of essential hypertension (EH). Therefore, we aimed to evaluate the association between size of EAT depots and the risk of EH taking into account its grade. Materials and Methods: Non-obese adult patients with various cardiovascular diseases were investigated: 157 of them had essential hypertension and 101 did not. Hypertensive patients were assigned to three groups according to the grade of hypertension. EAT volume and thickness on ventricular free walls (6 locations) and grooves (5 locations) were measured using cardiac magnetic resonance imaging and compared between groups. A regression model for the prediction of EH was constructed. Results: In general, thickness (in all locations) and volume of EAT depots was greater among hypertensive patients than in normotensive (NORM) group. Mean EAT thickness in all 11 locations and EAT volume were lower in NORM than in grade 1 hypertension group; similarly, EAT volume was lower in grade 1 than in grade 2 hypertension group. EAT accumulation did not differ between grade 2 and severe hypertension groups. EAT volume, dyslipidaemia status, body mass index, and age were independent predictors for EH in regression model. Conclusions: EAT accumulation is larger among hypertensive than normotensive individuals. Measurement of EAT depots could be beneficial for identification of hypertensive patients and prediction of hypertension severity.

Abstract 16339: Heparin Bridging in Atrial Fibrillation Patients After Temporary Interruption of Warfarin: Evidence From Meta-analysis

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Karam Ayoub ◽  
Ramez Nairooz ◽  
Ahmed Almomani ◽  
Meera Marji ◽  
Maria Pino ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
Confidence Interval ◽  
Major Bleeding ◽  
Odds Ratio ◽  
Observational Studies ◽  
Meta Analysis ◽  
Chads2 Score ◽  
Significant Difference ◽  
All Cause Mortality

Background: Patients with atrial fibrillation often require temporary interruption of warfarin for procedures. However, the efficacy of periprocedural heparin bridging in clinical practice is still unclear. Methods: We searched the literature for trials that compared heparin bridging to no bridging in atrial fibrillation patients for whom warfarin was temporarily interrupted. The incidence of all-cause mortality, thromboembolism, and major and all bleeding was included, and meta-analysis was performed. Results: A total of 11,924 patients with atrial fibrillation were included in 4 observational studies and 1 randomized trial. Mean CHADS2 score for the no heparin bridging group is 2.26 vs heparin bridging 2.26. At 30 days and up to 3 months, no bridging group in comparison to bridging group did not show any significant difference in mortality (odds ratio (OR), 1.22; 95% confidence interval (CI), 0.04-37.43; P = 0.91) or thromboembolism (OR, 0.69; 95% CI, 0.12-4.05; P = 0.68), but no bridging group showed significantly less major bleeding (OR, 0.43; 95% CI, 0.21-0.86; P = 0.02) and less all bleeding (OR, 0.43; 95% CI, 0.24-0.79; P = 0.007). Conclusion: Among atrial fibrillation patients anticoagulated with warfarin with an intermediate CHADS2 score requiring temporary interruption of warfarin for a procedure, periprocedural bridging with heparin was associated more with major and all bleeding when compared to no bridging, with no significant difference in mortality and thromboembolism.

scholarly journals The Association of Epicardial Adipose Tissue and High Risk Plaque Characteristics: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 26 ◽  
pp. S272
Author(s):  
N. Nerlekar ◽  
A. Brown ◽  
R. Muthalaly ◽  
A. Talman ◽  
J. Laggoune ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adipose Tissue ◽  
High Risk ◽  
Epicardial Adipose Tissue ◽  
Meta Analysis

scholarly journals Adherence to antihypertensive medications and associated factors among hypertensive patients in Ethiopia: Systematic review and meta-analysis

2020 ◽  
Vol 8 ◽  
pp. 205031212098245
Author(s):  
Assefa Tola Gemeda ◽  
Lemma Demissie Regassa ◽  
Adisu Birhanu Weldesenbet ◽  
Bedasa Taye Merga ◽  
Nanti Legesse ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medication Adherence ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Associated Factors ◽  
Antihypertensive Medication ◽  
Meta Analysis ◽  
Group Analysis ◽  
Hypertensive Patients ◽  
Pooled Prevalence

The foundation of controlling hypertension is adherence to antihypertensive medication adherence. This systematic review and meta-analysis aimed to assess the magnitude and associated factors of adherence to antihypertensive medication among adult hypertensive patients in Ethiopia. A comprehensible bibliographic searching was conducted from PubMed, EMBASE, Scopus, and Web of Science core collection. All published and unpublished studies that had been accessible before 31 May 2020, and written in English were eligible. Joanna Briggs Institute assessment tool was used to evaluate the quality of the findings of the included studies. Stata software 16.0 was used to analyze the data. Study-specific estimates were pooled to determine the overall prevalence estimate across studies using a random-effects meta-analysis model. Publication bias and heterogeneity were checked. Fourteen studies with a total of 4938 hypertensive patients were included in the final systematic review and meta-analysis. The pooled prevalence of medication adherence among hypertensive patients in Ethiopia was 65.41% (95% confidence interval: 58.91–71.91). Sub-group analysis shown that the pooled prevalence of medication adherence was the highest (69.07%, 95% confidence interval: 57.83–80.31, I2 = 93.51) among studies using questionnaire technique whereas the lowest in Morisky Medication Adherence Scale eight-items (60.66%, 95% confidence interval: 48.92–72.40, I2 = 97.16). Moreover, medication adherence was associated with the presence of comorbidities (pooled odds ratio = 0.23, 95% confidence interval: 0.07–0.38, p = 0.030, I2 = 54.9%) and knowledge about the disease and its management (pooled odds ratio = 2.98, 95% confidence interval: 1.72–4.24, p = 0.04, I2 = 55.55%) but not with place of residence (pooled odds ratio = 1.22, 95% confidence interval: 0.51–1.93, p = 0.00, I2 = 76.9%). Despite a lack of uniformity among included studies, adherence to antihypertensive medication among the hypertensive population in Ethiopia was moderate. The presence of comorbidities and/or complications reduced the odds of adherence whereas having good knowledge about the disease increased chance of medication adherence among hypertensive patients.

scholarly journals Coffee Consumption and Cardiovascular Diseases: A Mendelian Randomization Study

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2218
Author(s):  
Shuai Yuan ◽  
Paul Carter ◽  
Amy M. Mason ◽  
Stephen Burgess ◽  
Susanna C. Larsson
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
Intracerebral Hemorrhage ◽  
Genetic Variants ◽  
Odds Ratio ◽  
Observational Studies ◽  
Mendelian Randomization ◽  
Coffee Consumption ◽  
Uk Biobank ◽  
The Uk

Coffee consumption has been linked to a lower risk of cardiovascular disease in observational studies, but whether the associations are causal is not known. We conducted a Mendelian randomization investigation to assess the potential causal role of coffee consumption in cardiovascular disease. Twelve independent genetic variants were used to proxy coffee consumption. Summary-level data for the relations between the 12 genetic variants and cardiovascular diseases were taken from the UK Biobank with up to 35,979 cases and the FinnGen consortium with up to 17,325 cases. Genetic predisposition to higher coffee consumption was not associated with any of the 15 studied cardiovascular outcomes in univariable MR analysis. The odds ratio per 50% increase in genetically predicted coffee consumption ranged from 0.97 (95% confidence interval (CI), 0.63, 1.50) for intracerebral hemorrhage to 1.26 (95% CI, 1.00, 1.58) for deep vein thrombosis in the UK Biobank and from 0.86 (95% CI, 0.50, 1.49) for subarachnoid hemorrhage to 1.34 (95% CI, 0.81, 2.22) for intracerebral hemorrhage in FinnGen. The null findings remained in multivariable Mendelian randomization analyses adjusted for genetically predicted body mass index and smoking initiation, except for a suggestive positive association for intracerebral hemorrhage (odds ratio 1.91; 95% CI, 1.03, 3.54) in FinnGen. This Mendelian randomization study showed limited evidence that coffee consumption affects the risk of developing cardiovascular disease, suggesting that previous observational studies may have been confounded.

scholarly journals Bleeding Risk in Non-Valvular Atrial Fibrillation Patients Receiving Direct Oral Anticoagulants and Warfarin: A Systematic Review and Meta-Analysis of Observational Studies

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3672-3672 ◽  
Author(s):  
Yimin Pearl Wang ◽  
Rohan Kehar ◽  
Alla Iansavitchene ◽  
Alejandro Lazo-Langner
Keyword(s):  
Major Bleeding ◽  
Lower Risk ◽  
Observational Studies ◽  
Meta Analysis ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Factor Xa ◽  
Bleeding Risk ◽  
Risk Of Bleeding ◽  
Significant Difference

Introduction: The standard oral anticoagulant therapy administered to non-valvular AF patients has typically been Vitamin K Antagonists (VKA) particularly warfarin. In recent years, Direct Oral Anticoagulants (DOACs) including Direct Thrombin Inhibitors (DTI) and Direct Factor Xa inhibitors (FXa inhibitors) have become an alternative to warfarin. Randomized trials comparing warfarin and DOACs showed comparable effectiveness without significant additional major bleeding risk. However, bleeding events in RCTs may differ from those in daily use due to the routine exclusion of patients with a higher risk of bleeding from many studies. We aimed to assess bleeding risk between DOACs and warfarin in AF patients in observational studies and we also sought to determine differences between patients that were experienced or naïve to oral anticoagulants. Methods: A systematic literature search was conducted in the OVID MEDLINE® and EMBASE® electronic databases. Observational studies and randomized control trials (RCT) from 1990 to January 2019 were retrieved and examined by two independent reviewers. A pooled effect hazard ratio (HR) was calculated using a random effects model using the generic inverse variance method. Subgroup analyses according to previous exposure to anticoagulants, study type, funding type and DOAC type were conducted. The primary outcome was major bleeding risk. The secondary outcome was clinically relevant non-major bleeding. All studies must have used an established or validated definition of major bleeding. Results: The initial literature search identified 3359 potentially eligible citations. After primary screening, 150 articles were eligible for full text review and there were 35 studies including 2,356,201 patients that met the inclusion criteria. Overall, patients on DOACs were less likely to experience a bleeding event compared to warfarin (HR 0.78, 95%CI 0.71, 0.85, P&lt;0.001). The results were consistent when analyzing patients receiving DTIs or FXa inhibitors (DTI: HR 0.76, 95% CI 0.67,0.87; FXa inhibitors: HR 0.79, 95% CI 0.69,0.89). However, among patients receiving factor Xa inhibitors, there was a significant difference in the risk of bleeding according to individual drug. Among patients receiving rivaroxaban the risk of bleeding was similar to warfarin (HR 0.98, 95%CI 0.91,1.06, p=0.60) whereas in those receiving apixaban there was a 40% reduction in the risk of bleeding compared to warfarin (HR 0.60, 95%CI 0.50,0.71, p&lt;0.001) (Figure 1). Three studies reported information according to previous anticoagulant exposure. The overall pooled hazard ratio was 0.68 (95% CI 0.55, 0.82 p&lt;0.001) in favor of patients on DOACs. In the subgroup analysis of previous anticoagulant use, the risk of bleeding was lower for DOACs compared to warfarin in both the experienced population (HR 0.70, 95%CI 0.51, 0.96) and the naïve population (HR 0.64, 95% CI 0.47,0.87). However, heterogeneity was moderate to high among both subgroups. Conclusion: This review and meta-analysis of observational studies including over 2.3 million patients showed that overall DOACs have a lower risk of major bleeding and clinically relevant non-major bleeding compared to warfarin. Most importantly, although the pooled effect estimate did not differ between DTIs and FXa inhibitors, among patients receiving FXa inhibitors there was a significant difference between individual agents. Patients on apixaban had a significantly lower risk of bleeding compared to warfarin in contrast to patients on rivaroxaban who had a similar risk. Disclosures No relevant conflicts of interest to declare.

scholarly journals The association of fracture risk in atrial fibrillation patients and long-term anticoagulant therapy category: a systematic review and meta-analysis

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10683
Author(s):  
Jun Chen ◽  
Lingchun Lyu ◽  
Jiayi Shen ◽  
Chunlai Zeng ◽  
Cheng Chen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Hip Fracture ◽  
Fracture Risk ◽  
Hip Fractures ◽  
Observational Studies ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Hip Fracture Risk ◽  
Significant Difference

Objective Our study aimed to assess the risk of all fractures and hip fractures in patients with atrial fibrillation (AF) who took non-vitamin K antagonist oral anticoagulants (NOACs) compared to warfarin. Methods We searched PubMed, Embase, and Cochrane Library and Clinical Trials.gov Website. Reviewed related researches up to January 31, 2020, to identify studies with more than 12 months of follow-up data. The protocol for this systematic review and meta-analysis has been registered in the International Prospective Register of Systematic Reviews (PROSPERO Number: CRD42020156893). Results We included five RCT studies, and five observational studies that contained a total of 326,846 patients in our meta-analysis. Our meta-analysis showed that patients taken NOACs had no significant all fracture risk (RR = 0.91, 95% CI [0.81–1.01]) and hip fracture risk (RR = 0.92, 95% CI [0.82–1.03]) compared with those taken warfarin. Subanalysis showed that the risk of all fractures and hip fractures treated by NOACs were significant lower compared with warfarin in observational studies compared with RCT studies. Also, a subanalysis across the duration of anticoagulation showed the NOACs users have lower all fracture risk than warfarin users when the duration of anticoagulation ≤2 years (RR = 0.89, 95% CI [0.80–0.99]). Further analysis, significant lower all fracture risk in the rivaroxaban therapy (RR = 0.81; 95% CI [0.76–0.86]) compared with warfarin but no statistical significance in hip fracture. There were no significant difference of all fracture risk and hip fracture risk in dabigatran, apixaban, and edoxaban therapy compared with warfarin. Conclusion The meta-analysis demonstrated that NOACs associated with a significantly lower all fracture risk compared with warfarin when the duration of anticoagulation more than 2 years. Rivaroxaban users had lower risk of all fracture than warfarin users in AF patients. But there was no evidence to verify apixaban, edoxaban, and dabigatranin could decrease all fracture and hip fracture risk compared with warfarin.

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