scholarly journals Intensive versus Usual Control of Hypertension in the Prevention of Cardiovascular and Renal Outcomes: A Cumulative Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 44 (3) ◽  
pp. 384-395 ◽  
Author(s):  
Li Li ◽  
Ling Li
Keyword(s):  
Myocardial Infarction ◽  
Randomized Controlled Trials ◽  
Cardiac Death ◽  
Cardiovascular Events ◽  
Treatment Effects ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Renal Outcomes ◽  
Randomized Controlled ◽  
Major Cardiovascular Events

Background/Aims: Previous studies have reported inconsistent results regarding the treatment effects of intensive blood pressure (IBP) control in the prevention of cardiovascular and renal outcomes. We conducted this cumulative meta-analysis to evaluate the treatment effects of IBP control on cardiovascular and renal outcomes. Methods: We systematically searched PubMed, EMBASE, and the Cochrane Library databases from the date of their inception to October 2017, to identify randomized controlled trials (RCTs). The relative risks (RRs) with corresponding 95% confidence intervals (CIs) were used to evaluate the treatment effects of IBP control by using a random-effects model. Results: The final analysis included 20 RCTs involving 56,687 individuals. The summary RRs indicated that IBP control treatment significantly reduced the risk of major cardiovascular events (RR: 0.85; 95% CI: 0.77–0.94; p = 0.001), including myocardial infarction (RR: 0.87; 95% CI: 0.76–1.00; p = 0.044), stroke (RR: 0.77; 95% CI: 0.66–0.89; p < 0.001), and albuminuria (RR: 0.90; 95% CI: 0.84–0.97; p = 0.007). However, IBP control had no significant effect on heart failure (RR: 0.80; 95% CI: 0.62–1.03; p = 0.077), all-cause mortality (RR: 0.91; 95% CI: 0.81–1.02; p = 0.112), cardiac death (RR: 0.91; 95% CI: 0.75–1.12; p = 0.390), non-cardiac death (RR: 0.98; 95% CI: 0.86–1.12; p = 0.773), end-stage renal disease (RR: 0.90; 95% CI: 0.77–1.06; p = 0.203), and retinopathy (RR: 0.81; 95% CI: 0.66–1.00; p = 0.052). Conclusion: The findings of this study suggest that IBP control plays a beneficial role in the prevention of some major cardiovascular events, including myocardial infarction, stroke, and albuminuria.

scholarly journals Comparative Effect of Statins and Omega-3 Supplementation on Cardiovascular Events: Meta-Analysis and Network Meta-Analysis of 63 Randomized Controlled Trials Including 264,516 Participants

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2218 ◽  
Author(s):  
Tung Hoang ◽  
Jeongseon Kim
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Randomized Controlled Trials ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Omega 3 ◽  
Randomized Controlled

Statins and omega-3 supplementation have been recommended for cardiovascular disease prevention, but comparative effects have not been investigated. This study aimed to summarize current evidence of the effect of statins and omega-3 supplementation on cardiovascular events. A meta-analysis and a network meta-analysis of 63 randomized controlled trials were used to calculate pooled relative risks (RRs) and 95% confidence intervals (CIs) for the effects of specific statins and omega-3 supplementation compared with controls. Overall, the statin group showed significant risk reductions in total cardiovascular disease, coronary heart disease, myocardial infarction, and stroke; however, omega-3 supplementation significantly decreased the risks of coronary heart disease and myocardial infarction only, in the comparison with the control group. In comparison with omega-3 supplementation, pravastatin significantly reduced the risks of total cardiovascular disease (RR = 0.81, 95% CI = 0.72–0.91), coronary heart disease (RR = 0.75, 95% CI = 0.60–0.94), and myocardial infarction (RR = 0.71, 95% CI = 0.55–0.94). Risks of total cardiovascular disease, coronary heart disease, myocardial infarction, and stroke in the atorvastatin group were statistically lower than those in the omega-3 group, with RRs (95% CIs) of 0.80 (0.73–0.88), 0.64 (0.50–0.82), 0.75 (0.60–0.93), and 0.81 (0.66–0.99), respectively. The findings of this study suggest that pravastatin and atorvastatin may be more beneficial than omega-3 supplementation in reducing the risk of total cardiovascular disease, coronary heart disease, and myocardial infarction.

scholarly journals Effect of disease modifying anti-rheumatic drugs on major cardiovascular events: a meta-analysis of randomized controlled trials

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shivshankar Thanigaimani ◽  
James Phie ◽  
Smriti Krishna ◽  
Joseph Moxon ◽  
Jonathan Golledge
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Major Cardiovascular Events ◽  
Life Threatening ◽  
Funnel Plots ◽  
Disease Modifying

AbstractDisease modifying anti-rheumatic drugs (DMARDs) were developed to treat joint inflammation. There is growing evidence that anti-inflammatory drugs prevent major cardiovascular events (MACE). The aim of this systematic review and meta-analysis was to examine whether DMARDs reduce the risk of MACE. A systematic literature search was performed to identify randomized controlled trials (RCTs) testing the effect of DMARDs on cardiovascular events. The primary outcome was MACE defined as the first occurrence of non-fatal myocardial infarction (MI), non-fatal stroke or cardiovascular death. Secondary outcomes were myocardial infarction or stroke alone and all-cause mortality. Safety was assessed by fatal or life threatening infection. Meta-analyses were performed using random effect models and reported as risk ratios (RR) and 95% confidence intervals (CI). Study quality and publication bias were assessed using the Cochrane Collaboration’s tool for assessing risk of bias and funnel plots. Twelve RCTs involving 18,056 participants testing three different DMARDs subclasses (Tumor Necrosis Factor inhibitors—4 trials; Janus Kinase inhibitors—5 trials; Interleukin inhibitors—3 trials) were included. Meta-analysis suggested that none of the DMARD subclasses had any effect on MACE, MI alone, stroke alone, risk of fatal or life threatening infection or death. Risk of bias was high, low and unclear in five, six and one studies respectively. Funnel plots suggested a low possibility of publication bias. This meta-analysis suggests that DMARDs do not affect the incidence of MACE. More trials are needed for firm conclusions.

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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