Effect Of Metformin On All-Cause Mortality And Major Adverse Cardiovascular Events: An Updated Meta-Analysis Of Randomized Controlled Trials

2020 ◽  
Author(s):  
Matteo Monami ◽  
Riccardo Candido ◽  
Basilio Pintaudi ◽  
Giovanni Targher ◽  
Edoardo Mannucci ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Major Adverse Cardiovascular Events ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
All Cause Mortality

scholarly journals Is there value in prescribing colchicine in coronary artery disease for secondary prevention: a meta-analysis of over 5,000 patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.F Sunjaya ◽  
A.P Sunjaya
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Randomized Controlled Trials ◽  
Cardiovascular Events ◽  
Low Dose ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
All Cause Mortality ◽  
Artery Disease

Abstract Introduction Coronary Artery Disease (CAD) is the single greatest cause of mortality and loss of disability adjusted life years (DALYs) worldwide. Inflammation plays a central role in the pathogenesis of atherosclerosis, with numerous evidence from prospective studies indicating that increasing C-reactive protein levels (hs-CRP) are independently associated with increasing risk of cardiovascular events. Colchicine, is an inexpensive, potent anti-inflammatory drug considered as a staple therapy for gout. Recent studies have shown that colchicine use may prove to be useful in the prevention of cardiovascular events. Purpose In patients with coronary artery disease (CAD) does administration of low dose colchicine lead to reduced all-cause mortality, cardiovascular risk and morbidity. Methods A meta-analysis was performed based on randomized controlled trials obtained from Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Medline and Medline ahead of print published between 2000 and 2020. Main outcome measures include all-cause mortality, cardiovascular events, CRP levels and prevalence of CRP levels less than 2.0 mg/L. Data synthesis and analysis was done using RevMan 5.3 using a random effects model. Results A total of 5 randomized controlled trials, representing 5,430 patients were included in this meta-analysis. Three trials administered colchicine 1 mg/day while the rest were assigned colchicine. 5 mg/day. Administration of colchicine in CAD patients was found to reduce all-cause mortality (RR=0.66, 95% CI: 0.30 to 1.46, p=0.31) and major adverse cardiovascular events (MACE) (RR=0.61, 95% CI: 0.25 to 1.47, p=0.27), although results were non-significant. Reduced CRP levels (Mean difference = −0.88, 95% CI: −1.76 to 0.01, p=0.05) compared to control group as well as a higher prevalence of patients with CRP levels <2.0 mg/L were found (RR=2.27, 95% CI: 0.45 to 11.33, p=0.32), although results were non-significant. Discussion Few studies are available evaluating the benefits of low dose colchicine in CAD patients. The beneficial effects of colchicine has been proposed due to its ability to inhibit neutrophil chemotaxis which may reduce the risk of plaque instability. The use of colchicine for secondary prevention of CAD will require long-term use, which will require the need for preparations that address its intolerance (mostly gastrointestinal) to prevent early discontinuation of the medication. Conclusion There's limited evidence on the benefit of low dose colchicine in CAD patients. Further large scale randomized-controlled trials are needed, and its dose-response relationship ascertained before consideration of its use could be given in CAD patients. Funding Acknowledgement Type of funding source: None

scholarly journals The Influence of Liraglutide for Heart Failure: A Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 22 (6) ◽  
pp. E438-E444
Author(s):  
Yu Zhang ◽  
Qingmei Chen ◽  
Guangyin Huang ◽  
Lisha Wang
Keyword(s):  
Heart Failure ◽  
Randomized Controlled Trials ◽  
Cardiac Death ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Major Adverse Cardiovascular Events ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled

Introduction: The efficacy of liraglutide to treat heart failure remains controversial. We conducted a systematic review and meta-analysis to explore the influence of liraglutide on heart failure. Methods: We searched PubMed, EMbase, Web of Science, EBSCO, and Cochrane library databases through March 2018 for randomized controlled trials (RCTs) assessing the effect of liraglutide on cardiac function of heart failure. Meta-analysis is performed using the random-effect model. Results: Four RCTs involving 629 patients are included in the meta-analysis. Overall, compared with the control group for heart failure, liraglutide treatment significantly can reduce NT-proBNP (Std. MD = -3.06; 95% CI = -5.78 to -0.34; P = .03), and improve 6MWT (Std. MD=1.10; 95% CI = 0.75 to 1.44; P < .00001), but has no remarkable influence on LVEF change (Std. MD=1.10; 95% CI = -1.97 to 3.98; P = 0.51), LVEDV change (Std. MD = 6.26; 95% CI = -1.45 to 13.97; P = .11), LVESV change (Std. MD = -13.47; 95% CI = -31.04 to 4.10; P = .13), hospitalization for heart failure (RR = 1.18; 95% CI = 0.88 to 1.58; P = .27), major adverse cardiovascular events (RR = 1.55; 95% CI = -0.24 to 9.89; P = .64), and cardiac death (RR = 1.11; 95% CI = 0.61 to 2.04; P = .72). Conclusions: Liraglutide treatment has an important ability to reduce NT-proBNP and improve 6MWT for heart failure, but shows no important influence on LVEF, LVEDV, LVESV, hospitalization for heart failure, major adverse cardiovascular events, and cardiac death.

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