scholarly journals Prevalence and Impact of Atrial Fibrillation in Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (11) ◽  
pp. 2490
Author(s):  
Giulio Francesco Romiti ◽  
Bernadette Corica ◽  
Gregory Y. H. Lip ◽  
Marco Proietti
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Meta Analysis ◽  
Geographical Location ◽  
Treatment Strategies ◽  
Cardiovascular Complications ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
High Degree ◽  
Degree Of Heterogeneity

Background: In patients with COVID-19, cardiovascular complications are common and associated with poor prognosis. Among these, an association between atrial fibrillation (AF) and COVID-19 has been described; however, the extent of this relationship is unclear. The aim of this study is to investigate the epidemiology of AF in COVID-19 patients and its impact on all-cause mortality. Methods: A systematic review and meta-analysis were performed and reported according to PRISMA guidelines, and a protocol for this study was registered on PROSPERO (CRD42021227950). PubMed and EMBASE were systematically searched for relevant studies. A random-effects model was used to estimate pooled odds ratios (OR) and 95% confidence intervals (CI). Results: Overall, 31 studies were included in the analysis, with a total number of 187,716 COVID-19 patients. The prevalence of AF was found to be as high as 8% of patients with COVID-19 (95% CI: 6.3–10.2%, 95% prediction intervals (PI): 2.0–27.1%), with a high degree of heterogeneity between studies; a multiple meta-regression model including geographical location, age, hypertension, and diabetes showed that these factors accounted for more than a third of the heterogeneity. AF COVID-19 patients were less likely to be female but more likely older, hypertensive, and with a critical status than those without AF. Patients with AF showed a significant increase in the risk of all-cause mortality (OR: 3.97, 95% CI: 2.76–5.71), with a high degree of heterogeneity. A sensitivity analysis focusing on new-onset AF showed the consistency of these results. Conclusions: Among COVID-19 patients, AF is found in 8% of patients. AF COVID-19 patients are older, more hypertensive, and more likely to have a critical status. In COVID-19 patients, AF is associated with a 4-fold higher risk of death. Further studies are needed to define the best treatment strategies to improve the prognosis of AF COVID-19 patients.

Abstract 15090: Direct Oral Anticoagulation vs Vitamin K Antagonist in Atrial Fibrillation With Liver Disease: A Systematic Review and Meta-analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mahmoud El Iskandarani ◽  
Islam Shatla ◽  
Muhammad Khalid ◽  
Bara El Kurdi ◽  
Timir Paul ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Ischemic Stroke ◽  
Liver Disease ◽  
Vitamin K ◽  
Major Bleeding ◽  
Lower Risk ◽  
Meta Analysis ◽  
Vitamin K Antagonist ◽  
All Cause Mortality

Background: Current guidelines recommend against the use of direct oral anticoagulation (DOAC) therapy in patients with atrial fibrillation (AF) in the setting of significant liver disease (LD) due to lack of evidence in safety and efficacy studies. However, recently studies have investigated the role of DOAC in comparison to Vitamin K antagonist (VKA) in this category of patients. Therefore, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety of this approach. Hypothesis: DOAC is safe and effective compared to VKA in AF with LD patients. Method: Unrestricted search of the PubMed, EMBASE, and Cochrane databases performed from inception until June 1, 2020 for studies comparing DOAC with VKA including more than 100 AF patients with LD. Relevant data were extracted and analyzed using Revman 5.3 software. Hazard ratio (HR) and 95% Confidence interval (CI) were calculated using the random-effects model. Result: A total of 5 studies (3 retrospective and 2 post hoc analysis) were included examining 39,064 patients with AF and LD (25,398 DOAC vs 13,669 VKA). DOAC is associated with lower risk of major bleeding compared to VKA with a HR of 0.68 (95% CI 0.47-0.98; I 2 =53%), all-cause mortality (HR 0.74;95% CI 0.59-0.94; I 2 =61%), and intracranial bleeding (HR 0.48; 95% CI 0.40-0.58; I 2 =0). There was no significant difference in ischemic stroke risk (HR 0.73; 95% CI 0.47-1.14; I 2 =72%) and gastrointestinal bleeding risk (0.96; 95% CI 0.61-1.51; I 2 =41%) between DOAC and VKA. Conclusion: DOAC is non-inferior to VKA regarding ischemic stroke prevention in AF patients with LD. Moreover, DOAC is associated with a lower risk of major bleeding, intracranial bleeding and all-cause mortality. Further randomized trials are needed to validate our findings.

scholarly journals Publications after conference presentations: A systematic review of published studies

2020 ◽  
pp. 01-09
Author(s):  
Sandeep Grover ◽  
Dalton N ◽  
Siddharth Sarkar
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Publication Rate ◽  
Peer Evaluation ◽  
Weighted Mean ◽  
Conference Presentations ◽  
Poster Presentations ◽  
High Degree ◽  
Oral Presentations ◽  
Degree Of Heterogeneity

Background and aims: Conferences provide an opportunity to present findings to an audience of experts in the field and get feedback for putting the research in context. Since conference proceedings provide limited space for presenting the findings, research publications are able to provide a better platform for the wider reach, scrupulous peer evaluation, and temporal consolidation of the medical scientific material. This review attempts to collate the studies which have evaluated the abstract publication ratio of the conference presentations. Methods: The systematic review and meta-analysis included peer reviewed publications which quantitatively reported the publication rate of conference presentations. Results: A total of 28 studies were included, with sample sizes ranging from 82 to 1897 abstracts (total 17,172 abstracts). The publication rate ranged from 3.8% to 78.0%, with weighted mean publication rate of 41.8% (95% confidence interval of 34.1% to 49.5%). Oral presentations had a greater chance of being published as compared to poster presentations (odds ratio of 2.693, 95% confidence intervals of 1.285 to 5.646). There was high degree of heterogeneity in the findings. Conclusions: A small proportion of the conference presentations ispublished. Efforts should be made to improve the abstract publication ratio to improve the wider dissemination of the available research.

Abstract 20116: The Impact of Atrial Fibrillation Type on the Risk of Thromboembolism, Mortality and Bleeding: A Systematic Review and Meta-analysis

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Anand Ganesan ◽  
Derek Chew ◽  
Trent Hartshorne ◽  
Joseph B Selvanayagam ◽  
Philip Aylward ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Risk Ratio ◽  
Meta Analysis ◽  
Case Series ◽  
Outcome Data ◽  
Risk Models ◽  
Thromboembolic Risk ◽  
All Cause Mortality ◽  
The Impact

Introduction: Thromboembolic risk stratification schemes and clinical guidelines for atrial fibrillation regard risk as independent of classification into paroxysmal (PAF) and nonparoxysmal atrial fibrillation (NPAF). The aim of the current study was to conduct a systematic review and meta-analysis evaluating the impact of AF type on thromboembolism, bleeding and mortality. Hypothesis: AF type would predict rates of thromebolism, mortality and bleeding. Methods: Pubmed was searched for randomized controlled trials, cohort studies, and case series reporting prospectively collected clinical outcomes stratified by AF type. The incidence of thromboembolism, mortality and bleeding was extracted. Results: AF clinical outcome data was extracted from 12 studies containing 99,996 patients. The pooled unadjusted risk ratio (RR) for thromboembolism in NPAF vs. PAF was RR 1.339 (95% CI: 1.140-1.644, P<0.001). In studies providing estimates of thromboembolism risk adjusted for baseline clinical risk factors, the pooled adjusted hazard ratio (HR) in NPAF vs. PAF was HR 1.384 (95% CI, 1.191-1.608, P<0.001). The pooled unadjusted risk ratio for all-cause mortality in NPAF vs. PAF was RR 1.462 (95% CI: 1.255-1.703 P<0.001). The pooled adjusted HR for all-cause mortality in NPAF vs. PAF was HR 1.217 (95% CI: 1.085-1.365, P<0.001. Rates of bleeding in NPAF and PAF were similar, unadjusted RR 1.00 (95% CI 0.919-1.087, P=0.994), pooled adjusted HR 1.025 (95% CI: 0.898-1.170, P=0.715). Conclusions: These data suggest a need for re-evaluation of the paradigm of thromboembolic risk equivalence between PAF and NPAF, and emphasize AF type as a powerful predictor of AF-related morbidity and mortality. Future studies exploring integration of AF type into thromboembolic risk models are needed.

scholarly journals Atrial fibrillation and the risk for myocardial infarction, all-cause mortality and heart failure: A systematic review and meta-analysis

2017 ◽  
Vol 24 (14) ◽  
pp. 1555-1566 ◽  
Author(s):  
Vidar Ruddox ◽  
Irene Sandven ◽  
John Munkhaugen ◽  
Julie Skattebu ◽  
Thor Edvardsen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Systematic Review ◽  
Meta Analysis ◽  
All Cause Mortality

scholarly journals New-Onset Atrial Fibrillation in Patients With Primary Aldosteronism Receiving Different Treatment Strategies: Systematic Review and Pooled Analysis of Three Studies

2021 ◽  
Vol 12 ◽  
Author(s):  
Cheng-Hsuan Tsai ◽  
Ya-Li Chen ◽  
Chien-Ting Pan ◽  
Yen-Tin Lin ◽  
Po-Chin Lee ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Essential Hypertension ◽  
Primary Aldosteronism ◽  
Meta Analysis ◽  
Treatment Strategies ◽  
Cochrane Library ◽  
Mineralocorticoid Receptor Antagonist ◽  
Onset Atrial Fibrillation ◽  
New Onset

BackgroundPrimary aldosteronism (PA) is a common cause of secondary hypertension and associated with higher incidence of new-onset atrial fibrillation (NOAF). However, the effects of surgical or medical therapies on preventing NOAF in PA patents remain unclear. The aim of this meta-analysis study was to assess the risk of NOAF among PA patients receiving mineralocorticoid receptor antagonist (MRA) treatment, PA patients receiving adrenalectomy, and patients with essential hypertension.MethodsWe performed the meta-analysis of the randomized or observational studies that investigated the incidence rate of NOAF in PA patients receiving MRA treatment versus PA patients receiving adrenalectomy from database inception until December 01, 2020 which were identified from PubMed, Embase, and Cochrane Library.ResultsA total of 172 related studies were reviewed, of which three fulfilled the inclusion criteria, including a total of 2,705 PA patients. The results of meta-analysis demonstrated a higher incidence of NOAF among the PA patients receiving MRA treatment compared to the PA patients receiving adrenalectomy (pooled odds ratio [OR]: 2.83, 95% confidence interval [CI]: 1.76–4.57 in the random effects model, I2 = 0%). The pooled OR for the PA patients receiving MRA treatment compared to the patients with essential hypertension was 1.91 (95% CI: 1.11–3.28). The pooled OR for the PA patients receiving adrenalectomy compared to the patients with essential hypertension was 0.70 (95% CI: 0.28–1.79).ConclusionCompared to the essential hypertension patients and the PA patients receiving adrenalectomy, the patients with PA receiving MRA treatment had a higher risk of NOAF.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42021222022.

scholarly journals Diabetes Mellitus and Breast Cancer Outcomes: A Systematic Review and Meta-Analysis

2011 ◽  
Vol 29 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Kimberly S. Peairs ◽  
Bethany B. Barone ◽  
Claire F. Snyder ◽  
Hsin-Chieh Yeh ◽  
Kelly B. Stein ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Diabetes Mellitus ◽  
Systematic Review ◽  
English Language ◽  
Meta Analysis ◽  
Original Data ◽  
Risk Of Death ◽  
Diabetes Status ◽  
All Cause Mortality ◽  
Prognostic Outcome

Purpose The goal of this study was to perform a systematic review and meta-analysis to examine the effect of pre-existing diabetes on breast cancer–related outcomes. Methods We searched EMBASE and MEDLINE databases from inception through July 1, 2009, using search terms related to diabetes mellitus, cancer, and prognostic outcome. Studies were included if they reported a prognostic outcome by diabetes status, evaluated a cancer population, and contained original data published in the English language. We performed a meta-analysis of pre-existing diabetes and its effect on all-cause mortality in patients with breast cancer and qualitatively summarized other prognostic outcomes. Results Of 8,828 titles identified, eight articles met inclusion/exclusion criteria and described outcomes in patients with breast cancer and diabetes. Pre-existing diabetes was significantly associated with all-cause mortality in six of seven studies. In a meta-analysis, patients with breast cancer and diabetes had a significantly higher all-cause mortality risk (pooled hazard ratio [HR], 1.49; 95% CI, 1.35 to 1.65) compared with their nondiabetic counterparts. Three of four studies found pre-existing diabetes to be associated with more advanced stage at presentation. Diabetes was also associated with altered regimens for breast cancer treatment and increased toxicity from chemotherapy. Conclusion Compared with their nondiabetic counterparts, patients with breast cancer and pre-existing diabetes have a greater risk of death and tend to present at later stages and receive altered treatment regimens. Studies are needed to investigate pathophysiologic interactions between diabetes and breast cancer and determine whether improvements in diabetes care can reduce mortality in patients with breast cancer.

scholarly journals Prevalence of Atrial Fibrillation and Associated Mortality Among Hospitalized Patients With COVID-19: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Zuwei Li ◽  
Wen Shao ◽  
Jing Zhang ◽  
Jianyong Ma ◽  
Shanshan Huang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Clinical Impact ◽  
Hospitalized Patients ◽  
Cochrane Library ◽  
Increased Risk ◽  
All Cause Mortality ◽  
New Onset

Background: Epidemiological studies have shown that atrial fibrillation (AF) is a potential cardiovascular complication of coronavirus disease 2019 (COVID-19). We aimed to perform a systematic review and meta-analysis to clarify the prevalence and clinical impact of AF and new-onset AF in patients with COVID-19.Methods: PubMed, Embase, the Cochrane Library, and MedRxiv up to February 27, 2021, were searched to identify studies that reported the prevalence and clinical impact of AF and new-onset AF in patients with COVID-19. The study was registered with PROSPERO (CRD42021238423).Results: Nineteen eligible studies were included with a total of 21,653 hospitalized patients. The pooled prevalence of AF was 11% in patients with COVID-19. Older (≥60 years of age) patients with COVID-19 had a nearly 2.5-fold higher prevalence of AF than younger (&lt;60 years of age) patients with COVID-19 (13 vs. 5%). Europeans had the highest prevalence of AF (15%), followed by Americans (11%), Asians (6%), and Africans (2%). The prevalence of AF in patients with severe COVID-19 was 6-fold higher than in patients with non-severe COVID-19 (19 vs. 3%). Furthermore, AF (OR: 2.98, 95% CI: 1.91 to 4.66) and new-onset AF (OR: 2.32, 95% CI: 1.60 to 3.37) were significantly associated with an increased risk of all-cause mortality among patients with COVID-19.Conclusion: AF is quite common among hospitalized patients with COVID-19, particularly among older (≥60 years of age) patients with COVID-19 and patients with severe COVID-19. Moreover, AF and new-onset AF were independently associated with an increased risk of all-cause mortality among hospitalized patients with COVID-19.

Abstract 12813: Atrial Fibrillation and Heart Failure With Preserved Ejection Fraction: A Systematic Review and Meta-analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mohan Satish ◽  
Raviteja Guddeti ◽  
Florian Wenzl ◽  
Ryan Walters ◽  
Venkata M Alla
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Systematic Review ◽  
Ejection Fraction ◽  
Meta Analysis ◽  
Excess Risk ◽  
Mortality Data ◽  
Preserved Ejection Fraction ◽  
Increased Risk ◽  
All Cause Mortality

Introduction: Due to shared risk factors and pathophysiology, atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF) frequently coexist. However, the prognostic implications of AF in HFpEF are unclear with conflicting data. Herein, we conducted a systematic review and meta-analysis to assess the impact of concomitant AF on cardiovascular outcomes in patients with HFpEF. Methods: PubMed, Scopus, and Google Scholar were comprehensively searched through May 7th, 2020 for studies comparing outcomes of HFpEF patients with and without AF. Outcomes assessed were all-cause mortality and a composite of HF hospitalization or cardiovascular (CV) mortality. Data from selected studies were abstracted and pooled using a random-effects meta-analysis to calculate odds ratios (ORs) and 95% confidence intervals [CIs] for each of the outcomes. Results: Our final analysis included 10 studies with 27,440 HFpEF patients (43.2% with AF). AF was associated with significantly increased risk of all-cause mortality (OR 1.37 [1.17-1.61], p < 0.001, Fig. 1A), HF hospitalization or CV mortality (OR 1.66 [1.16-2.36], p = 0.005, Fig. 1B), and HF hospitalization alone (OR 1.34 [1.03-1.76], p = 0.03, Fig. 1C). However, AF was not associated with excess risk of CV mortality alone (OR 1.10 [0.79-1.52], p = 0.57, Fig. 1D). Conclusions: In patients with HFpEF, concomitant AF is associated with an increased risk of all-cause mortality and HF hospitalization. Further research into the mechanisms and interventions to mitigate this excess risk is necessary.

scholarly journals Direct comparison of non-vitamin K antagonist oral anticoagulant versus warfarin for stroke prevention in non-valvular atrial fibrillation: a systematic review and meta-analysis of real-world evidences

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Yoga Waranugraha ◽  
Ardian Rizal ◽  
Mokhamad Fahmi Rizki Syaban ◽  
Icha Farihah Deniyati Faratisha ◽  
Nabila Erina Erwan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Vitamin K ◽  
Real World ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Bleeding Risk ◽  
Vitamin K Antagonist ◽  
The Real ◽  
All Cause Mortality

Abstract Background To overcome the several drawbacks of warfarin, non-vitamin K antagonist oral anticoagulants (NOACs) were developed. Even though randomized controlled trials (RCTs) provided high-quality evidence, the real-world evidence is still needed. This systematic review and meta-analysis proposed to measure the safety and efficacy profile between warfarin and NOACs in non-valvular atrial fibrillation (NVAF) patients in preventing stroke. Results We collected articles about the real-world studies comparing warfarin and NOACs for NVAF patients recorded in electronic scientific databases such as Embase, ProQuest, PubMed, and Cochrane. The pooled hazard ratio (HR) and 95% confidence interval (CI) were estimated using the generic inverse variance method. A total of 34 real-world studies, including 2287288 NVAF patients, were involved in this study. NOACs effectively reduced the stroke risk than warfarin (HR 0.77; 95% CI 0.69 to 0.87; p < 0.01). Moreover, NOACs effectively lowered all-cause mortality risk (HR 0.71; 95% CI 0.63 to 0.81; p < 0.01). From the safety aspect, compared to warfarin, NOACs significantly reduced major bleeding risk (HR 0.68; 95% CI 0.54 to 0.86; p < 0.01) and intracranial bleeding risk (HR 0.54; 95% CI 0.42 to 0.70; p < 0.01). However, NOACs administration failed to decrease gastrointestinal bleeding risk (HR 0.78; 95% CI 0.58 to 1.06; p = 0.12). Conclusions In NVAF patients, NOACs were found to be more effective than warfarin at reducing stroke risk. NOACSs also lowered the risk of all-cause mortality, cerebral hemorrhage, and severe bleeding in NVAF patients compared to warfarin.

Sign in / Sign up

Export Citation Format

Share Document