scholarly journals Coronary Artery Calcification Under Statin Therapy and Its Effect on Cardiovascular Outcomes: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 7 ◽  
Author(s):  
Runmin Lai ◽  
Jianqing Ju ◽  
Qian Lin ◽  
Hao Xu
Keyword(s):  
Systematic Review ◽  
Coronary Artery ◽  
Statin Therapy ◽  
Coronary Artery Calcification ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Cardiovascular Outcomes ◽  
Small Sample ◽  
The Relationship

Objective: To compare Agatston scores between patients without statin therapy and those under standard and intensive statin therapy and to systematically review the relationship between coronary artery calcification (CAC) progression under statin therapy and cardiovascular outcomes.Methods: Literature search was conducted across databases. Randomized controlled trials and observational studies that reported Agatston scores at baseline and follow-up from patients with and without statin therapy were included. A systematic review and meta-analysis was conducted.Results: Seven studies were subjected to qualitative and quantitative analyses. Agatston scores in all groups were increased at follow-up. Meta-analysis of data from the included studies revealed an insignificantly lower CAC score at follow-up in the experimental groups. Subgroup analysis showed that statins slowed down CAC progression mildly but with statistical significance in population with baseline CAC score >400 in the experimental groups (P = 0.009). Despite that calcification progressors had worse cardiovascular outcome than did non-progressors, it appeared that baseline CAC score had more decisive effects on cardiovascular outcomes. CAC progression under statin therapy did not increase cardiovascular risk, although more supportive data are needed.Conclusion: Statins do not reduce or enhance CAC as measured by Agatston score in asymptomatic populations at high risk of cardiovascular diseases, but seem to slow down CAC progression. Although our result was robust, it was restricted by small sample size and relatively short follow-up period. Further studies on the relationship between CAC progression under statin therapy and cardiovascular outcomes are needed.

scholarly journals DPP4 inhibitors and respiratory infection, a systematic review and meta-analysis of the CardioVascular Outcomes Trials conducted before the pandemic and implications for the management of diabetes during COVID-19

2020 ◽  
Author(s):  
Guillaume Grenet ◽  
Samia Mekhaldi ◽  
Sabine MAINBOURG ◽  
Marine AUFFRET ◽  
Catherine Cornu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sensitivity Analysis ◽  
Respiratory Infection ◽  
Respiratory Infections ◽  
Meta Analysis ◽  
Cardiovascular Outcomes ◽  
Previous Systematic Review ◽  
Dpp4 Inhibitors

Background Association between DPP4 inhibitors and respiratory infection remains unclear. CardioVascular Outcomes Trials (CVOTs) conducted before the COVID-19 pandemic are available. We aimed to estimate the effect of DPP4 inhibitors on the risk of respiratory infections. Methods We updated a previous systematic review and meta-analysis, searching for CVOTs assessing a DPP4 inhibitor in patients with type 2 diabetes mellitus. We focused on placebo-controlled CVOTs. Our primary outcome was 'any respiratory infection'. We added a sensitivity analysis integrating non-CVOTs and active-controlled CVOTs. Findings We included 47 714 patients in five placebo-controlled CVOTs. Median follow-up ranged from 1.5 years to 3 years. 4 369 events of overall respiratory infection were reported (rate of 9.2%). DPP4 inhibitors were not associated with a different risk compared to placebo (RR = 0.99 [95%CI: 0.93; 1.04]). The sensitivity analysis integrating the non-CVOTs studies and the active-controlled CVOT reached 11 349 events among 82 644 participants (rate of 13.7%). DPP4 inhibitors were not associated with a different risk of overall respiratory infection (RR = 1.00 [95% CI: 0.97; 1.03]). Interpretation Our up-dated meta-analysis provides the most powerful and least biased estimation of the association of DPP4 inhibitors and the risk of overall (non COVID-19) respiratory infection. We did not find any effect of the DPP4 inhibitors on the risk of respiratory infection. Our results support the recently published practical recommendations for the management of diabetes in patients with COVID-19, suggesting that DPP4 inhibitors should not be discontinued regarding the COVID-19 pandemic.

Sign in / Sign up

Export Citation Format

Share Document