Association Between Prior Calcium Channel Blocker Use and Mortality in Septic Patients: A Meta-Analysis of Cohort Studies

Background: The aim of this study was to comprehensively review the literature and synthesize the evidence concerning the relationship between prior calcium channel blocker (CCB) use and mortality in patients with sepsis.Methods: The Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), Cochrane CENTRAL, and Web of Science databases were searched from their inception to April 9, 2020. Cohort studies related to prior calcium channel blocker use in patients with sepsis were analyzed. Pairs of reviewers independently screened the studies, extracted the data, and assessed the risk of bias. The primary outcome of 90-days mortality or secondary outcome of short-term mortality, including 30-days, Intensive Care Unit (ICU), and in-hospital mortality, were analyzed. Heterogeneity among studies was assessed using the I2 statistic and was considered moderate if I2 was 50–75% and high if I2 was ≥75%. Random-effects models were used to calculate the pooled odds ratios (ORs) and 95% confidence intervals (CIs). The quality of the studies was evaluated with the Newcastle-Ottawa Scale (NOS). Sensitivity analyses were performed to examine the robustness of the results.Results: In total, 639 potentially relevant studies were identified, and the full texts of 25 articles were reviewed. Ultimately, five cohort studies involving 280,982 patients were confirmed to have a low risk of bias and were included. Prior CCB use was associated with a significantly lower 90-days mortality in sepsis patients [OR, 0.90 (0.85–0.95); I2 = 31.9%]. Moreover, prior CCB use was associated with a significantly reduced short-term mortality rate in septic shock patients [OR, 0.61 (0.38–0.97); I2 = 62.4%] but not in sepsis patients [OR, 0.83 (0.66–1.04); I2 = 95.4%].Conclusion: This meta-analysis suggests that prior CCB use is significantly associated with improved 90-days mortality in sepsis patients and short-term mortality in septic shock patients. This study provides preliminary evidence of an association between prior CCB use and mortality in sepsis patients.

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Association between Prior Calcium Channel Blocker use and Mortality in Septic Patients: A Meta-Analysis of Cohort Studies

10.21203/rs.3.rs-41244/v1 ◽

2020 ◽

Author(s):

Xianfei Ding ◽

Yuqing Cui ◽

Yanhui Zhu ◽

Huoyan Liang ◽

Dong Wang ◽

...

Keyword(s):

Septic Shock ◽

Cohort Studies ◽

Calcium Channel ◽

Calcium Channel Blocker ◽

Channel Blocker ◽

Meta Analysis ◽

Risk Of Bias ◽

Sensitivity Analyses ◽

Sepsis Management ◽

Term Survival

Abstract Background: To comprehensively review the literature and synthesize evidence concerning the relationship between preadmission calcium channel blocker (CCB) use and mortality in patients with sepsis.Methods: The MEDLINE, EMBASE, and Cochrane CENTRAL databases were searched from their inception to April 9, 2020. Cohort studies that related to prior CCB use in patients with sepsis were analysed. Pairs of reviewers independently screened studies, extracted data, and assessed the risk of bias. Two primary outcomes related to mortality, namely, 30-day mortality and 90-day mortality, were analysed; heterogeneity between studies was assessed using I2 and was considered moderate if I2 was equivalent to 50–75% and high if I2 ≥ 75%. Fixed and random-effects models were used to calculate the pooled odds ratios (ORs) and 95% confidence intervals (CIs). The quality of outcomes was evaluated with the Newcastle-Ottawa Scale (NOS). Sensitivity analyses were performed to examine the robustness of the results.Results: 552 potentially relevant studies were identified, and the full texts of 25 articles were reviewed. Ultimately, five cohort studies involving 280,982 patients were confirmed to have a low risk of bias and were included. Preadmission CCB use was associated with a significantly lower 30-day mortality in septic shock (OR, 0.61 [0.38-0.97]; P = 0.035; I2 = 62.4%), not in sepsis (OR, 0.83 [0.66-1.04]; P = 0.103; I2 = 95.4%). Moreover, prior CCB use could significantly reduce 30-day mortality in sepsis (OR, 0.90 [0.85-0.95]; P < 0.001; I2 = 31.9%). Conclusions: This meta-analysis suggests that preadmission CCB use is significantly associated with improving long-term prognosis of sepsis, and also short-term survival of septic shock patients. This finding may provide an attractive direction for sepsis management.

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Calcium Channel Blocker-Associated Chyloperitoneum in Patients Receiving Peritoneal Dialysis: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16081333 ◽

2019 ◽

Vol 16 (8) ◽

pp. 1333 ◽

Cited By ~ 1

Author(s):

Seungyeon Kim ◽

Yun Mi Yu ◽

Jeongyoon Kwon ◽

Hyejin Yoo ◽

Sun Hoi Jung ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Cohort Studies ◽

Calcium Channel ◽

Calcium Channel Blocker ◽

Healthcare Professionals ◽

Channel Blocker ◽

Case Reports ◽

Case Series ◽

Risk Of Bias ◽

Clinical Conditions

Unlike chyloperitoneum associated with clinical conditions including cancer, cirrhosis, and traumatic surgery, calcium channel blocker (CCB)-associated chyloperitoneum is rarely discussed in comprehensive studies on chyloperitoneum. We aimed to investigate the prevalence and characteristics of CCB-associated chyloperitoneum in peritoneal dialysis (PD) patients. The MEDLINE, Embase, CENTRAL, CiNii, and RISS databases were systematically searched for clinical studies on CCB-associated chyloperitoneum in PD patients published up to 31 July 2018. A total of 17 studies (four cohort studies, one case series, and 12 case reports) were selected. Eight CCBs, namely amlodipine, benidipine, diltiazem, lercanidipine, manidipine, nifedipine, nisoldipine, and verapamil, were reported to be associated with chyloperitoneum; manidipine and lercanidipine were the most frequently reported. The average prevalence of chyloperitoneum for lercanidipine was 25.97% in three cohort studies, two of which had a moderate or high risk of bias. Most of the studies revealed chyloperitoneum development within 4 days of initiation of CCB therapy and chyloperitoneum disappearance within 24 h of CCB withdrawal. The results of this study emphasise on the need for awareness among healthcare professionals regarding CCB-associated chyloperitoneum in PD patients. Further studies elucidating the causality and clinical implication of CCB-associated chyloperitoneum are needed.

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Association of calcium channel blocker use with clinical outcome of COVID-19: A meta-analysis

Diabetes & Metabolic Syndrome Clinical Research & Reviews ◽

10.1016/j.dsx.2021.102210 ◽

2021 ◽

pp. 102210

Author(s):

Mochamad Yusuf Alsagaff ◽

Eka Prasetya Budi Mulia ◽

Irma Maghfirah ◽

Kevin Luke ◽

David Nugraha ◽

...

Keyword(s):

Clinical Outcome ◽

Calcium Channel ◽

Calcium Channel Blocker ◽

Channel Blocker ◽

Meta Analysis

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Efficacy of Cilnidipine (L/N-type Calcium Channel Blocker) in Treatment of Hypertension: A Meta-Analysis of Randomized and Non-randomized Controlled Trials

Cureus ◽

10.7759/cureus.19822 ◽

2021 ◽

Author(s):

Rabindra Nath Chakraborty ◽

Deepak Langade ◽

Shyam More ◽

Vaibhav Revandlkar ◽

Ashish Birla

Keyword(s):

Calcium Channel ◽

Randomized Controlled Trials ◽

Calcium Channel Blocker ◽

Channel Blocker ◽

Meta Analysis ◽

Controlled Trials ◽

Randomized Controlled ◽

Treatment Of Hypertension

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Racial Differences in Blood Pressure Response to Calcium Channel Blocker Monotherapy: A Meta-Analysis

American Journal of Hypertension ◽

10.1038/ajh.2009.100 ◽

2009 ◽

Vol 22 (8) ◽

pp. 911-917 ◽

Cited By ~ 9

Author(s):

T. T. Nguyen ◽

J. S. Kaufman ◽

E. A. Whitsel ◽

R. S. Cooper

Keyword(s):

Blood Pressure ◽

Calcium Channel ◽

Racial Differences ◽

Calcium Channel Blocker ◽

Channel Blocker ◽

Blood Pressure Response ◽

Meta Analysis ◽

Pressure Response

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The Effect of Early Vasopressin Use on Patients With Septic Shock: A Systematic Review and Meta-analysis

10.21203/rs.3.rs-99744/v1 ◽

2020 ◽

Author(s):

Haijun Huang ◽

Chenxia Wu ◽

Qinkang Shen ◽

Hua Xu ◽

Yixin Fang ◽

...

Keyword(s):

Septic Shock ◽

Length Of Stay ◽

Meta Analysis ◽

Mean Difference ◽

Short Term ◽

Vasopressin Infusion ◽

Icu Length Of Stay ◽

Short Term Mortality ◽

Length Of Hospitalization ◽

New Onset

Abstract Background: The effect of early vasopressin initiation on clinical outcomes in patients with septic shock is uncertain. A systematic review and meta-analysis was performed to evaluate the impact of early start of vasopressin support within 6 hours after the diagnosis on clinical outcomes in septic shock patients.Methods: We searched the PubMed, Cochrane, and Embase databases for randomized controlled trials (RCTs) and cohort studies from inception to the 1st of October 2020. We included studies involving adult patients (> 16 years)with septic shock. All authors reported our primary outcome of short-term mortality and in the experimental group patients in the studies receiving vasopressin infusion within 6 hours after diagnosis of septic shock and in the control group patients in the studies receiving no vasopressin infusion or vasopressin infusion 6 hours after diagnosis of septic shock, clearly comparing with clinically relevant secondary outcomes(use of renal replacement therapy(RRT),new onset arrhythmias, ICU length of stay and length of hospitalization). Results were expressed as odds ratio (OR) and mean difference (MD) with accompanying 95% confidence interval (CI).Results: Five studies including 788 patients were included. The primary outcome of this meta-analysis showed that short-term mortality between the two groups was no difference (odds ratio [OR] = 1.09; 95% CI, 0.8 to 1.48; P =0.6; χ2 =0.83; I2 = 0%). Secondary outcomes demonstrated that the use of RRT was less in the experimental group than that of the control group (OR =0.63; 95% CI, 0.44 to 0.88; P =0.007; χ2 =3.15; I2 =36%).The new onset arrhythmias between the two groups was no statistically significant difference (OR =0.59; 95% CI, 0.31 to 1.1; P =0.10; χ2 =4.7; I2 =36%). There was no statistically significant difference in the ICU length of stay(mean difference = 0.16; 95% CI, - 0.91 to 1.22; P = 0.77; χ2 = 6.08; I2 =34%) and length of hospitalization (mean difference = -2.41; 95% CI, -6.61 to 1.78; P = 0.26; χ2 = 8.57; I2 =53%) between the two groups.Conclusions: Early initiation of vasopressin in patients within 6 hours of septic shock onset was not associated with decreased short-term mortality, new onset arrhythmias, shorter ICU length of stay and length of hospitalization, but can reduce the use of RRT. Further large-scale RCTs are still needed to evaluate the benefit of starting vasopressin in the early phase of septic shock.

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Efficacy of Chloroquine or Hydroxychloroquine in COVID-19 Patients: A Systematic Review and Meta-Analysis

10.1101/2020.07.12.20150110 ◽

2020 ◽

Author(s):

Zakariya Tarek Kashour ◽

Muhammad Riaz ◽

Musa garbati ◽

Oweida Aldosary ◽

Haytham Tlayjeh ◽

...

Keyword(s):

Systematic Review ◽

Mechanical Ventilation ◽

Cohort Studies ◽

Meta Analysis ◽

Grey Literature ◽

Random Effect Model ◽

Viral Clearance ◽

Short Term ◽

Icu Admission ◽

Short Term Mortality

Background The antimalarial agents, chloroquine (CQ) and hydroxychloroquine (HCQ) show promising SARS-CoV-2 anti-viral activity in vitro; however, clinical studies have reported conflicting results. We sought to systematically evaluate the effect of CQ and HCQ with or without azithromycin (AZ) on outcomes of COVID-19 patients. Methods We performed a systematic review and meta-analysis of studies published through July 7, 2020. We searched Medline, Embase, EBM Reviews, Scopus, Web of Science, preprints and grey literature. We included studies that assessed COVID-19 patients treated with CQ or HCQ, with or without AZ. We pooled only adjusted effect estimates of mortality using a random effect model and estimated between studies heterogeneity using I2 statistic. We summarized the effect of CQ or HCQ on viral clearance and ICU admission/ mechanical ventilation. Results Out of 1463 citations screened for eligibility, five RCTs and 14 cohort studies were included (20,263 patients, all hospitalized but with a variable disease severity spectrum). Thirteen studies (1 RCT and 12 cohorts) with 19,573 patients examined the effect of HCQ on short term mortality. The pooled adjusted OR was 1.05 (95% CI 0.96-1.15, I2=0 %, p=0.647). Six cohort studies examined the effect of HCQ and AZ combination among 3430 patients. After excluding a study that examined only patients with cancers, the pooled adjusted OR was (1.15, 95% CI 0.99-1.34, I2=0.0%). Two cohort studies and three RCTs found no significant effect of HCQ on viral clearance. One RCT with 48 patients demonstrated improved viral clearance in patients treated with CQ and HCQ. Three cohort studies found that HCQ with or without AZ had no significant effect on mechanical ventilation/ ICU admission. Conclusion Moderate certainty evidence suggests that HCQ, with or without AZ, lacks efficacy in reducing short-term mortality in patients hospitalized with COVID-19. Our findings are consistent with the recommendations from medical societies that HCQ should only be used to treat COVID-19 patients in the context of clinical trials. Trials of HCQ as pre-exposure prophylaxis are ongoing.

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