Risk of stroke in patients with congenital heart disease: a systematic review and meta-analysis.

IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY
Ramez M Odat, Muhammad Idrees, Hritvik Jain, Sakhr Alshwayyat, Husam Aldean H Hussain, Basma Badrawy Khalefa, Ali O Aldamen, Abdel Rahman K Bani Yaseen, Bassel Alrabadi, Mohammad-Amer A Tamimi, Ayham Mohammad Hussein, Hamdah Hanifa, Osama Aloudat
{"title":"Risk of stroke in patients with congenital heart disease: a systematic review and meta-analysis.","authors":"Ramez M Odat, Muhammad Idrees, Hritvik Jain, Sakhr Alshwayyat, Husam Aldean H Hussain, Basma Badrawy Khalefa, Ali O Aldamen, Abdel Rahman K Bani Yaseen, Bassel Alrabadi, Mohammad-Amer A Tamimi, Ayham Mohammad Hussein, Hamdah Hanifa, Osama Aloudat","doi":"10.1186/s12883-024-03967-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Patients with congenital heart disease (CHD) are more likely to experience ischemic and hemorrhagic stroke due to factors such as arrhythmias, residual shunts and related cardiovascular complications. However, guidelines for identifying CHD patients at the highest risk of stroke remain unclear. In this study, we aimed to evaluate the risk of developing stroke in patients with CHD.</p><p><strong>Methods: </strong>A systematic literature search was performed on PubMed, Scopus, Cochrane, and Embase databases to retrieve studies that evaluated stroke risk in patients with CHD. Random effects model was used to pool the hazard ratios (HR) with 95% confidence intervals (CI). Subgroup analysis was conducted on age, type of stroke, type of study and region. Publication bias was assessed by Egger's regression test. Statistical significance was set at p < 0.05. All the analysis was performed using R studio V4.3.1.</p><p><strong>Results: </strong>Eleven studies (5,490,412 participants) were included in this systematic review and meta-analysis. Patients with CHD were at a higher risk of stroke [Pooled HR: 3.25; 95% CI: 2.25, 4.68; p < 0.01; I<sup>2</sup>: 100%] than the control group. In subgroup analysis, patients with CHD were at a higher risk of ischemic stroke [Pooled HR: 4.45; 95% CI: 2.24, 8.85; p < 0.01; I<sup>2</sup>: 100%] and hemorrhagic stroke [Pooled HR: 4.70; 95% CI: 1.70, 12.96; p < 0.01; I<sup>2</sup>: 99%] than the control group.</p><p><strong>Conclusion: </strong>Our meta-analysis indicates a significantly increased stroke risk in patients with CHD. Subgroup analyses showed higher stroke risk in European regions compared to Asia and USA, and among adults compared to pediatric populations. Future studies should focus on addressing regional and data limitations to better inform clinical strategies for managing stroke risk in CHD patients.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"24 1","pages":"465"},"PeriodicalIF":2.2000,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605865/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12883-024-03967-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Patients with congenital heart disease (CHD) are more likely to experience ischemic and hemorrhagic stroke due to factors such as arrhythmias, residual shunts and related cardiovascular complications. However, guidelines for identifying CHD patients at the highest risk of stroke remain unclear. In this study, we aimed to evaluate the risk of developing stroke in patients with CHD.

Methods: A systematic literature search was performed on PubMed, Scopus, Cochrane, and Embase databases to retrieve studies that evaluated stroke risk in patients with CHD. Random effects model was used to pool the hazard ratios (HR) with 95% confidence intervals (CI). Subgroup analysis was conducted on age, type of stroke, type of study and region. Publication bias was assessed by Egger's regression test. Statistical significance was set at p < 0.05. All the analysis was performed using R studio V4.3.1.

Results: Eleven studies (5,490,412 participants) were included in this systematic review and meta-analysis. Patients with CHD were at a higher risk of stroke [Pooled HR: 3.25; 95% CI: 2.25, 4.68; p < 0.01; I2: 100%] than the control group. In subgroup analysis, patients with CHD were at a higher risk of ischemic stroke [Pooled HR: 4.45; 95% CI: 2.24, 8.85; p < 0.01; I2: 100%] and hemorrhagic stroke [Pooled HR: 4.70; 95% CI: 1.70, 12.96; p < 0.01; I2: 99%] than the control group.

Conclusion: Our meta-analysis indicates a significantly increased stroke risk in patients with CHD. Subgroup analyses showed higher stroke risk in European regions compared to Asia and USA, and among adults compared to pediatric populations. Future studies should focus on addressing regional and data limitations to better inform clinical strategies for managing stroke risk in CHD patients.

先天性心脏病患者卒中风险:系统回顾和荟萃分析
背景:先天性心脏病(CHD)患者由于心律失常、残留分流及相关心血管并发症等因素更容易发生缺血性和出血性卒中。然而,确定冠心病患者中风风险最高的指南仍不明确。在这项研究中,我们旨在评估冠心病患者发生脑卒中的风险。方法:对PubMed、Scopus、Cochrane和Embase数据库进行系统的文献检索,检索评估冠心病患者卒中风险的研究。采用随机效应模型将风险比(HR)与95%置信区间(CI)合并。对年龄、脑卒中类型、研究类型和地区进行亚组分析。采用Egger回归检验评价发表偏倚。结果:11项研究(5,490,412名受试者)纳入本系统评价和荟萃分析。冠心病患者发生卒中的风险更高[合并HR: 3.25;95% ci: 2.25, 4.68;[P 2: 100%]。在亚组分析中,冠心病患者发生缺血性卒中的风险更高[合并风险比:4.45;95% ci: 2.24, 8.85;p 2: 100%]和出血性卒中[合并风险比:4.70;95% ci: 1.70, 12.96;[P 2: 99%]。结论:我们的荟萃分析表明冠心病患者卒中风险显著增加。亚组分析显示,欧洲地区的中风风险高于亚洲和美国,成年人的中风风险高于儿童。未来的研究应侧重于解决区域和数据限制,以更好地为管理冠心病患者卒中风险的临床策略提供信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
BMC Neurology
BMC Neurology 医学-临床神经学
CiteScore
4.20
自引率
0.00%
发文量
428
审稿时长
3-8 weeks
期刊介绍: BMC Neurology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of neurological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信