Impact of activity trackers on secondary prevention in patients with coronary artery disease: a systematic review and meta-analysis (Preprint)

2021 ◽  
Author(s):  
Toshiki Kaihara ◽  
Valent Intan-Goey ◽  
Martijn Scherrenberg ◽  
Maarten Falter ◽  
Ines Frederix ◽  
...  
Keyword(s):  
Secondary Prevention ◽  
Positive Impact ◽  
Meta Analysis ◽  
Peak Oxygen Consumption ◽  
Cochrane Library ◽  
Major Adverse Cardiovascular Events ◽  
Cvd Risk ◽  
Activity Tracker ◽  
Activity Trackers ◽  
Peak Vo2

BACKGROUND Ischemic heart disease (IHD) is related to high rates of morbidity and mortality among cardiovascular diseases (CVD). Activity trackers have been used in cardiac rehabilitation (CR) in the last years. However, their effectiveness to influence outcomes after IHD is debated. OBJECTIVE This review summarizes the latest data of impact of activity trackers on CVD risk and outcomes. METHODS Articles from 1986 to 2020 in English were searched by electronic databases (PubMed, Cochrane Library, Embase). Inclusion criteria were: randomized controlled trials of IHD secondary prevention using an activity tracker which include at least peak oxygen consumption (VO2), major adverse cardiovascular events (MACE), quality of life (QoL), LDL-cholesterol (LDL-C) as outcomes. Meta-analysis and qualitative analysis were performed. RESULTS After removing duplicates, 604 articles were included and the screening identified a total of 11 articles. Compared to control groups, intervention groups with activity trackers significantly increased peak VO2 (mean difference 1.54; 95% CI [0.50–2.57]; P=.004) and decreased MACE (risk ratio 0.51; 95% CI [0.31–0.86]; P=.01). Heterogeneity was low (I2=0%) for MACE and high (I2=51%) for peak VO2. Intervention with an activity tracker also has positive impact on QoL in qualitative analyses. There was no between-group difference in LDL-C. CONCLUSIONS CR using activity trackers has a positive and multi-faceted effect on peak VO2, MACE, and QoL in patients with IHD.

454 ASSOCIATION BETWEEN STATINS AND MAJOR ADVERSE CARDIAC EVENTS AMONG OLDER ADULTS WITH FRAILTY: A SYSTEMATIC REVIEW

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii5-ii7
Author(s):  
M Hale ◽  
H Zaman ◽  
D Mehdizadeh ◽  
O Todd ◽  
H Callaghan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Primary Prevention ◽  
Secondary Prevention ◽  
Randomised Trial ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Major Adverse Cardiovascular Events ◽  
Primary And Secondary Prevention ◽  
Cardiac Events

Abstract Background Statins reduce the risk of major adverse cardiovascular events (MACE), however, their clinical benefit for primary and secondary prevention among older adults with frailty is uncertain. This review investigates whether statins prescribed for primary and secondary prevention are associated with reduced MACE among adults aged ≥65 years with frailty. Methods Systematic review of studies published between 01.01.1952 and 01.01.2019 in MEDLINE, Embase, Scopus, Web of Science, Cochrane Library and the International Pharmaceutical Abstracts. Studies that investigated the effect of statins on MACE among adults ≥65 years with a validated frailty assessment were included. Data were extracted from the papers as per a pre-published protocol, PROSPERO: CRD42019127486. Risk of bias was assessed using the Cochrane Risk of Bias in non-randomised studies of interventions. Finding 18794 abstracts were identified for screening. From these, six cohort studies fulfilled the inclusion criteria. There were no randomised clinical trials. Of studies involving statins for primary and secondary prevention (n = 6), one found statins were associated with reduced mortality (hazard ratio (HR) 0.58, 95% confidence interval (CI) 0.37–0.93) and another found they were not (p = 0.73). One study of statins used for secondary prevention found they were associated with reduced mortality (HR 0.28, 95%CI 0.21–0.39). No studies investigated the effect of statins for primary prevention or the effect of statins on the frequency of MACE. Discussion This review summarizes the existing available evidence for decision making for statin prescribing for older adults with frailty. This study identified only observational evidence that, among older people with frailty, statins are associated with reduced mortality when prescribed for secondary prevention, and an absence of evidence evaluating statin therapy for primary prevention. The findings of this study highlight that randomised trial data are urgently needed to better inform the use of statins among older adults living with frailty.

scholarly journals Predicting major adverse cardiovascular events for secondary prevention: protocol for a systematic review and meta-analysis of risk prediction models

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e034564
Author(s):  
Ralph K Akyea ◽  
Jo Leonardi-Bee ◽  
Folkert W Asselbergs ◽  
Riyaz S Patel ◽  
Paul Durrington ◽  
...  
Keyword(s):  
Secondary Prevention ◽  
Cardiovascular Events ◽  
Prediction Models ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Prognostic Models ◽  
Major Adverse Cardiovascular Events ◽  
Bibliographic Databases ◽  
Analysis Model

IntroductionCardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. With advances in early diagnosis and treatment of CVD and increasing life expectancy, more people are surviving initial CVD events. However, models for stratifying disease severity risk in patients with established CVD for effective secondary prevention strategies are inadequate. Multivariable prognostic models to stratify CVD risk may allow personalised treatment interventions. This review aims to systematically review the existing multivariable prognostic models for the recurrence of CVD or major adverse cardiovascular events in adults with established CVD diagnosis.Methods and analysisBibliographic databases (Ovid MEDLINE, EMBASE, PsycINFO and Web of Science) will be searched, from database inception to April 2020, using terms relating to the clinical area and prognosis. A hand search of the reference lists of included studies will also be done to identify additional published studies. No restrictions on language of publications will be applied. Eligible studies present multivariable models (derived or validated) of adults (aged 16 years and over) with an established diagnosis of CVD, reporting at least one of the components of the primary outcome of major adverse cardiovascular events (defined as either coronary heart disease, stroke, peripheral artery disease, heart failure or CVD-related mortality). Reviewing will be done by two reviewers independently using the pre-defined criteria. Data will be extracted for included full-text articles. Risk of bias will be assessed using the Prediction model study Risk Of Bias ASsessment Tool (PROBAST). Prognostic models will be summarised narratively. If a model is tested in multiple validation studies, the predictive performance will be summarised using a random-effects meta-analysis model to account for any between-study heterogeneity.Ethics and disseminationEthics approval is not required. The results of this study will be submitted to relevant conferences for presentation and a peer-reviewed journal for publication.PROSPERO registration numberCRD42019149111.

scholarly journals Efficacy and safety of intradialytic exercise in haemodialysis patients: a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e020633 ◽  
Author(s):  
Jiang Pu ◽  
Zheng Jiang ◽  
Weihua Wu ◽  
Li Li ◽  
Liling Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Short Form ◽  
Meta Analysis ◽  
The Body ◽  
Peak Oxygen Consumption ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Sf 36 ◽  
Intradialytic Exercise

ObjectiveTo assess the efficacy and safety of intradialytic exercise for haemodialysis patients.DesignSystematic review and meta-analysis.Data sourcesDatabases, including PubMed, Embase, the Cochrane Library, China Biology Medicine and China National Knowledge Infrastructure, were screened from inception to March 2017.Eligibility criteriaRandomised controlled trials (RCTs) aimed at comparing the efficacy and safety of intradialytic exercise versus no exercise in adult patients on haemodialysis for at least 3 months. A minimum exercise programme period of 8 weeks.Data extractionStudy characteristics and study quality domains were reviewed. Studies were selected, and data extracted by two reviewers.Data analysisThe pooled risk ratios and mean differences (MDs) with 95% CIs for dichotomous data and continuous data were calculated, respectively.ResultsA total of 27 RCTs involving 1215 subjects were analysed. Compared with no exercise, intradialytic exercise increased dialysis adequacy (Kt/V) (MD 0.07, 95% CI 0.01 to 0.12, p=0.02) and maximum volume of oxygen that the body can use during physical exertion peak oxygen consumption (MD 4.11, 95% CI 2.94 to 5.27, p<0.0001), alleviated depression standardised mean difference (−1.16, 95% CI −1.86 to –0.45, p=0.001) and improved physical component summary-short form-36 (SF-36) level (MD 7.72, 95% CI 1.93 to 13.51, p=0.009). Also, intradialytic exercise could significantly reduce systolic blood pressure (MD −4.87, 95% CI −9.20 to –0.55, p=0.03) as well as diastolic blood pressure (MD −4.11, 95% CI −6.50 to –1.72, p=0.0007). However, intradialytic exercise could not improve mental component summary-SF-36 level (MD 3.05, 95% CI −1.47 to 7.57, p=0.19). There was no difference in the incidence of adverse events between the intradialytic exercise and control groups.ConclusionsIntradialytic exercise resulted in benefits in terms of improving haemodialysis adequacy, exercise capacity, depression and quality of life for haemodialysis.

LMWH in the prevention of preeclampsia and fetal growth restriction in women without thrombophilia

2016 ◽  
Vol 116 (11) ◽  
pp. 868-878 ◽  
Author(s):  
Salvatore Mastrolia ◽  
Lena Novack ◽  
Jecko Thachil ◽  
Anat Rabinovich ◽  
Oleg Pikovsky ◽  
...  
Keyword(s):  
Secondary Prevention ◽  
Risk Reduction ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Meta Analysis ◽  
Research Question ◽  
Random Effect ◽  
Growth Restriction ◽  
Cochrane Library ◽  
Inclusion Criteria

SummaryPlacental mediated pregnancy complications such as preeclampsia and fetal growth restriction (FGR) are common, serious, and associated with increased morbidity and mortality. We conducted a systematic review and meta-analysis to determine the effect of treatment with low-molecular-weight heparins (LMWHs) for secondary prevention of these complications in non thrombophilic women. We searched the electronic databases PubMed, Scopus, and Cochrane Library for randomised controlled trials addressing this question. Five studies including 403 patients met the inclusion criteria, 68 developed preeclampsia and 118 FGR. The studies were very heterogeneous in terms of inclusion criteria, LMWH preparation, and dosage. Meta-analyses were performed using random-effect models. The overall use of LMWHs was associated with a risk reduction for preeclampsia (Relative risk (RR) 0.366; 95 % confidence interval (CI), 0.219–0.614) and FGR (RR 0.409; 95 % CI, 0.195–0.932) vs. no treatment. From the data available for analysis it appears that the use of Dalteparin is associated with a risk reduction for preeclampsia (p=0.002) and FGR (p<0.001); while Enoxaparin is associated with risk reduction for preeclampsia (p=0.013) but not for FGR (p=0.3). In spite of the small number of studies addressing the research question, and the high variability among them, our meta-analysis found a modest beneficial effect of LMWH for secondary prevention of preeclampsia and FGR. Further studies are needed to address these questions before a definite conclusion can be reached.Supplementary Material to this article is available online at www.thrombosis-online.com.

Abstract 13640: Effects of Influenza Vaccine on Mortality and Cardiovascular Outcomes Ii Patients With Cardiovascular Disease: A Systematic Review and Meta-analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Siva Harsha Yedlapati ◽  
Safi U Khan ◽  
Swapna Talluri ◽  
Ahmad Naeem Lone ◽  
Muhammad KHAN ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Influenza Vaccine ◽  
Observational Studies ◽  
Influenza Infection ◽  
Meta Analysis ◽  
Cardiovascular Outcomes ◽  
Cochrane Library ◽  
Major Adverse Cardiovascular Events ◽  
The Mean

Introduction: Influenza infection is associated with increased morbidity and mortality in patients with cardiovascular disease (CVD). We assessed the effects of influenza vaccine on mortality and cardiovascular outcomes in patients with CVD. Hypothesis: Influenza vaccination in those with CVD is associated with a reduction in mortality and major adverse cardiovascular events (MACE). Methods: We searched PubMed, EMBASE, and Cochrane library through January 2020 for randomized-controlled trials (RCTs) and observational studies assessing effects of influenza vaccine on mortality and cardiovascular outcomes in patients with CVD. Estimates were reported as random effects risk ratios (RR) with 95% confidence intervals (CI). Analyses were stratified by study design into RCT and observational studies. Results: Overall, 16 studies (n=237,058) encompassing 4 RCTs (n=1,667) and 12 observational studies (n=235,391) were included. The mean age was 69.2±7.01; 36.6% were female, 65.1% had hypertension, 31.1% had diabetes, and 23.4% were smokers. The median follow-up duration was 19.5 (IQR, 12, 43.3) months. Influenza vaccine was associated with a lower risk of all-cause mortality (RR, 0.72 [95% CI, 0.59-0.89], p<0.001) ( Figure 1A ), cardiovascular mortality (RR, 0.82 [95% CI, 0.80-0.84], p<0.001), and MACE (RR, 0.87 [95% CI, 0.80-0.94], p<0.001) ( Figure 1B ), though the association with myocardial infarction was not statistically significant (RR, 0.73 [95% CI, 0.50-1.07]; p=0.10). These finding were consistent across randomized and observational studies. Conclusions: This meta-analysis suggests that both randomized and observational data support the use of influenza vaccine in adults with CVD to reduce mortality and MACE events. Efforts to improve utilization of influenza vaccine in this population should continue to reap survival benefits.

scholarly journals Estimating the prevalence of heterozygous familial hypercholesterolaemia: a systematic review and meta-analysis

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016461 ◽  
Author(s):  
Leo E Akioyamen ◽  
Jacques Genest ◽  
Shubham D Shan ◽  
Rachel L Reel ◽  
Jordan M Albaum ◽  
...  
Keyword(s):  
Systematic Review ◽  
Familial Hypercholesterolaemia ◽  
Meta Analysis ◽  
Geographical Location ◽  
Significant Risk ◽  
Sensitivity Analyses ◽  
Cochrane Library ◽  
Cvd Risk ◽  
Premature Cardiovascular Disease ◽  
Heterozygous Familial Hypercholesterolaemia

ObjectivesHeterozygous familial hypercholesterolaemia (FH) confers a significant risk for premature cardiovascular disease (CVD). However, the estimated prevalence of FH varies substantially among studies. We aimed to provide a summary estimate of FH prevalence in the general population and assess variations in frequency across different sociodemographic characteristics.Setting, participants and outcome measuresWe searched MEDLINE, EMBASE, Global Health, the Cochrane Library, PsycINFO and PubMed for peer-reviewed literature using validated strategies. Results were limited to studies published in English between January 1990 and January 2017. Studies were eligible if they determined FH prevalence using clinical criteria or DNA-based analyses. We determined a pooled point prevalence of FH in adults and children and assessed the variation of the pooled frequency by age, sex, geographical location, diagnostic method, study quality and year of publication. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were investigated through subgroups, meta-regression and sensitivity analyses.ResultsThe pooled prevalence of FH from 19 studies including 2 458 456 unique individuals was 0.40% (95% CI 0.29% to 0.52%) which corresponds to a frequency of 1 in 250 individuals. FH prevalence was found to vary by age and geographical location but not by any other covariates. Results were consistent in sensitivity analyses.ConclusionsOur systematic review suggests that FH is a common disorder, affecting 1 in 250 individuals. These findings underscore the need for early detection and management to decrease CVD risk.

Efficacy of Glutathione for Patients With Cystic Fibrosis: A Meta-analysis of Randomized-Controlled Studies

2019 ◽  
Vol 34 (1) ◽  
pp. 115-121 ◽  
Author(s):  
Jinqiu Zhao ◽  
Wenxiang Huang ◽  
Shujun Zhang ◽  
Jing Xu ◽  
Wei Xue ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pulmonary Function ◽  
Positive Impact ◽  
Meta Analysis ◽  
Forced Expiratory Volume ◽  
Cochrane Library ◽  
Control Group ◽  
Randomized Controlled ◽  
Randomized Controlled Studies ◽  
The Impact

Introduction The impact of glutathione on pulmonary function remains elusive for patients with cystic fibrosis. The aim of this systematic review and meta-analysis is to explore the influence of glutathione versus placebo on pulmonary function of cystic fibrosis. Methods We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through May 2019, and randomized-controlled trials (RCTs) regarding the effect of glutathione on pulmonary function of cystic fibrosis are included in this meta-analysis. Results Four RCTs are included. Compared with control group in patients with cystic fibrosis, glutathione treatment shows positive impact on forced expiratory volume 1 second (FEV1) (mean difference [MD] = 0.19; 95% confidence interval (CI), 0.10–0.28; P < .0001) and body mass index (MD = 0.27; 95% CI, 0.02–0.51; P = .03), but has no obvious influence on 6-minute walk test (standard MD = 0.28; 95% CI, −0.08 to 0.64; P = .13), number of exacerbations (MD = −0.10; 95% CI, −0.34 to 0.15; P = .43), abdominal pain or distal intestinal obstruction (risk ratios [RR] = 0.78; 95% CI, 0.32–1.90; P = .58), or hemoptysis (RR = 1.87; 95% CI, 0.43–8.26; P = .41). Conclusions Glutathione treatment provides some benefits to improve pulmonary function of patients with cystic fibrosis, as evidenced by the increase in FEV1.

scholarly journals RISK OF INFERTILITY IN PATIENTS WITH CELIAC DISEASE: a meta-analysis of observational studies

2014 ◽  
Vol 51 (2) ◽  
pp. 144-150 ◽  
Author(s):  
Juan Sebastian LASA ◽  
Ignacio ZUBIAURRE ◽  
Luis Oscar SOIFER
Keyword(s):  
Celiac Disease ◽  
Positive Impact ◽  
Meta Analysis ◽  
Autoimmune Disorder ◽  
Cochrane Library ◽  
Reproductive Disorders ◽  
Design Studies ◽  
Cohort Design ◽  
And Control ◽  
The Relationship

ContextCeliac disease is an autoimmune disorder of the small intestine associated with several extra-intestinal features, such as reproductive disorders. The relationship between celiac disease and infertility has been previously assessed, with conflicting results.ObjectivesWe seek to determine the relationship between celiac disease and infertility.MethodsData was extracted from case-control or cohort design studies from 1966 to December 2013 using the MEDLINE-Pubmed, EMBASE, LILACS and Cochrane Library databases. We analyzed two kinds of trials: those assessing the risk of infertility in subjects with already diagnosed celiac disease, and those evaluating the prevalence of undiagnosed celiac disease in subjects with a diagnosis of infertility.ResultsThe search yielded 413 potentially relevant studies for revision, 12 of which were finally included for analysis. A significant association was found between women with a diagnosis of infertility and undiagnosed celiac disease [OR 3.09 (95% CI 1.74-5.49)]. When considering those studies assessing the occurrence of infertility in subjects with already-diagnosed celiac disease, no difference was found between celiac disease patients and control subjects [OR 0.99 (0.86-1.13)].ConclusionsUndiagnosed celiac disease is a risk factor for infertility. Women seeking medical advice for this particular condition should be screened for celiac disease. Adoption of a gluten-free diet could have a positive impact on fertility in this group of patients.

scholarly journals Is School Gardening Combined with Physical Activity Intervention Effective for Improving Childhood Obesity? A Systematic Review and Meta-Analysis

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2605
Author(s):  
Yufei Qi ◽  
Sareena Hanim Hamzah ◽  
Erya Gu ◽  
Haonan Wang ◽  
Yue Xi ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Weight Status ◽  
Physical Activity Intervention ◽  
Positive Impact ◽  
Meta Analysis ◽  
Overweight And Obesity ◽  
Cochrane Library ◽  
Obvious Effect ◽  
Randomized Controlled ◽  
School Gardening

School gardening activities (SGA) combined with physical activities (PA) may improve childhood dietary intake and prevent overweight and obesity. This study aims to evaluate the effect of SGA combined with PA on children’s dietary intake and anthropometric outcomes. We searched studies containing randomized controlled trials up to January 2021 in Web of Science, PubMed, Cochrane Library, and the EBSCO database on this topic for children aged 7 to 12 years. Fourteen studies met the requirements for meta-analysis (n = 9187). We found that SGA has no obvious effect on improving children’s BMI (WMD = −0.49; p = 0.085; I2 = 86.3%), BMI z-score (WMD = −0.12; p = 0.235; I2 = 63.0%), and WC (WMD = −0.98; p = 0.05; I2 = 72.9%). SGA can effectively improve children’s FVs (WMD = 0.59, p = 0.003, I2 = 95.3%). SGA combined with PA can significantly increase children’s FVs but cannot greatly improve weight status. Although more studies on this topic are needed to prove the effectiveness of this method, the results of our review show that both SGA and SGA combined with PA has a modest but positive impact of reducing BMI and WC outcomes but can significantly increase children’s FVs.

scholarly journals Systematic review and meta-analysis for prevention of cardiovascular complications using GLP-1 receptor agonists and SGLT-2 inhibitors in obese diabetic patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kazushi Uneda ◽  
Yuki Kawai ◽  
Takayuki Yamada ◽  
Sho Kinguchi ◽  
Kengo Azushima ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Indirect Comparison ◽  
Cardiovascular Complications ◽  
Cochrane Library ◽  
Major Adverse Cardiovascular Events ◽  
Diabetic Patients ◽  
Receptor Agonists ◽  
Sodium Glucose Cotransporter ◽  
Significant Difference ◽  
Glucagon Like Peptide 1

AbstractPatients with type 2 diabetes mellitus (T2DM) and obesity are at high risk of developing cardiovascular disease (CVD). Both glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter (SGLT-2) inhibitors have been shown to prevent CVD in T2DM patients. Additionally, the two drugs reduce body mass. However, it is unknown which drug is more effective at reducing the risk of CVD in such patients. We searched Medline, EMBASE, and Cochrane Library records to February 20, 2021 and performed a network meta-analysis to compare the efficacy with which the drugs reduced the risk of major adverse cardiovascular events (MACE). We included 102,728 patients in 12 studies containing data of obesity subgroup analyses. In T2DM patients with obesity, GLP-1 RAs significantly reduced the risk of MACE versus placebo (relative risk, RR [95% confidence interval, CI]: 0.88 [0.81–0.96]), whereas SGLT-2 inhibitors showed a tendency (RR [95% CI]: 0.91 [0.83–1.00]). In an indirect comparison, GLP-1 RAs were not associated with a significant difference in MACE compared with SGLT-2 inhibitors (RR [95% CI]: 0.97 [0.85–1.09]). Thus, GLP-1 RAs are effective at preventing MACE than placebo in T2DM patients with obesity, although further studies are warranted to conclude their superiority to SGLT-2 inhibitors.

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