分层查加斯病急性缺血性卒中和脑血管事件的临床相关危险因素：系统回顾和荟萃分析

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology Pub Date : 2024-12-01 DOI:10.1016/j.cpcardiol.2024.102950

Ocílio Ribeiro Gonçalves M.S. , Saul Dominici M.S. , Júlia dos Santos Monteiro M.S. , Elizabet Taylor Pimenta Weba M.S. , Anthony Hong M.S. , Ana Beatriz Santos M.S. , Maria Tereza Camarotti M.S. , Niels Pacheco M.D. , João Victor Araújo de Oliveira M.S. , Arlindo Bispo da Silva Junior M.S. , Márcio Yuri Ferreira M.D. , Kelson James Almeida M.D. Ph.D.

{"title":"分层查加斯病急性缺血性卒中和脑血管事件的临床相关危险因素：系统回顾和荟萃分析","authors":"Ocílio Ribeiro Gonçalves M.S. , Saul Dominici M.S. , Júlia dos Santos Monteiro M.S. , Elizabet Taylor Pimenta Weba M.S. , Anthony Hong M.S. , Ana Beatriz Santos M.S. , Maria Tereza Camarotti M.S. , Niels Pacheco M.D. , João Victor Araújo de Oliveira M.S. , Arlindo Bispo da Silva Junior M.S. , Márcio Yuri Ferreira M.D. , Kelson James Almeida M.D. Ph.D.","doi":"10.1016/j.cpcardiol.2024.102950","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Chagas Disease (CD) poses significant health risks, including an increased incidence of acute ischemic stroke (AIS). However, the specific risk factors for AIS in CD patients are not well-defined. This meta-analysis aims to identify clinically relevant risk factors for AIS in individuals with CD.</div></div><div><h3>Methods</h3><div>We performed a systematic review and meta-analysis by searching PubMed, Embase, Web of Science, and the Cochrane Library up to August 2024. Primary outcomes evaluated in AIS patients with CD included reduced left ventricular ejection fraction (LVEF), anticoagulation therapy, atrial fibrillation (AF), left ventricular apical aneurysm (LVAA), pacemaker use, and coronary artery disease (CAD). Risk ratios (RRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model.</div></div><div><h3>Results</h3><div>Six studies were included, involving 1,229 patients (48% male). The analysis revealed a higher risk of AIS in CD patients with reduced LVEF (RR 3.38; 95% CI 1.38 - 8.27), AF (OR 4.85; 95% CI 2.13 - 11.02), LVAA (OR 3.76; 95% CI 1.96 - 7.21), and pacemaker use (OR 2.37; 95% CI 1.38 - 4.09). Anticoagulation therapy was associated with a reduced likelihood of stroke (OR 0.28; 95% CI 0.19 - 0.41). No significant association was found between CAD and stroke risk (OR 1.56; 95% CI 0.93 - 2.59).</div></div><div><h3>Conclusion</h3><div>Reduced LVEF, AF, LVAA, and pacemaker use are correlated with higher stroke incidence in CD patients, while anticoagulation therapy diminishes this risk. Further randomized studies are needed to refine AIS prevention strategies for this population.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 3","pages":"Article 102950"},"PeriodicalIF":3.0000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Stratifying clinically relevant risk factors for acute ischemic stroke and cerebrovascular events in chagas disease: A systematic review and meta-Analysis\",\"authors\":\"Ocílio Ribeiro Gonçalves M.S. , Saul Dominici M.S. , Júlia dos Santos Monteiro M.S. , Elizabet Taylor Pimenta Weba M.S. , Anthony Hong M.S. , Ana Beatriz Santos M.S. , Maria Tereza Camarotti M.S. , Niels Pacheco M.D. , João Victor Araújo de Oliveira M.S. , Arlindo Bispo da Silva Junior M.S. , Márcio Yuri Ferreira M.D. , Kelson James Almeida M.D. Ph.D.\",\"doi\":\"10.1016/j.cpcardiol.2024.102950\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Chagas Disease (CD) poses significant health risks, including an increased incidence of acute ischemic stroke (AIS). However, the specific risk factors for AIS in CD patients are not well-defined. This meta-analysis aims to identify clinically relevant risk factors for AIS in individuals with CD.</div></div><div><h3>Methods</h3><div>We performed a systematic review and meta-analysis by searching PubMed, Embase, Web of Science, and the Cochrane Library up to August 2024. Primary outcomes evaluated in AIS patients with CD included reduced left ventricular ejection fraction (LVEF), anticoagulation therapy, atrial fibrillation (AF), left ventricular apical aneurysm (LVAA), pacemaker use, and coronary artery disease (CAD). Risk ratios (RRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model.</div></div><div><h3>Results</h3><div>Six studies were included, involving 1,229 patients (48% male). The analysis revealed a higher risk of AIS in CD patients with reduced LVEF (RR 3.38; 95% CI 1.38 - 8.27), AF (OR 4.85; 95% CI 2.13 - 11.02), LVAA (OR 3.76; 95% CI 1.96 - 7.21), and pacemaker use (OR 2.37; 95% CI 1.38 - 4.09). Anticoagulation therapy was associated with a reduced likelihood of stroke (OR 0.28; 95% CI 0.19 - 0.41). No significant association was found between CAD and stroke risk (OR 1.56; 95% CI 0.93 - 2.59).</div></div><div><h3>Conclusion</h3><div>Reduced LVEF, AF, LVAA, and pacemaker use are correlated with higher stroke incidence in CD patients, while anticoagulation therapy diminishes this risk. Further randomized studies are needed to refine AIS prevention strategies for this population.</div></div>\",\"PeriodicalId\":51006,\"journal\":{\"name\":\"Current Problems in Cardiology\",\"volume\":\"50 3\",\"pages\":\"Article 102950\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Problems in Cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0146280624005851\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Problems in Cardiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0146280624005851","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

摘要

背景：恰加斯病（CD）具有显著的健康风险，包括急性缺血性卒中（AIS）的发病率增加。然而，乳糜泻患者AIS的具体危险因素尚未明确。本荟萃分析旨在确定cd患者AIS的临床相关危险因素。方法：我们通过检索PubMed， Embase， Web of Science和Cochrane图书馆进行了系统回顾和荟萃分析，截止到2024年8月。评估AIS合并CD患者的主要结局包括左室射血分数（LVEF）降低、抗凝治疗、心房颤动（AF）、左室顶动脉瘤（LVAA）、起搏器使用和冠状动脉疾病（CAD）。采用随机效应模型计算95%置信区间（ci）的风险比（rr）和优势比（ORs）。结果：纳入6项研究，涉及1229例患者（48%为男性）。分析显示，LVEF降低的CD患者发生AIS的风险更高(RR 3.38；95% ci 1.38 - 8.27), af(或4.85；95% ci 2.13 - 11.02), lvaa(或3.76；95% CI 1.96 - 7.21)，起搏器使用(OR 2.37；95% ci 1.38 - 4.09)。抗凝治疗与卒中可能性降低相关(OR 0.28；95% ci 0.19 - 0.41)。冠心病与卒中风险之间没有显著关联(OR 1.56；95% ci 0.93 - 2.59)。结论：降低LVEF、AF、lveaa和使用起搏器与CD患者卒中发生率升高相关，而抗凝治疗可降低这一风险。需要进一步的随机研究来完善针对这一人群的AIS预防策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Stratifying clinically relevant risk factors for acute ischemic stroke and cerebrovascular events in chagas disease: A systematic review and meta-Analysis

Background

Chagas Disease (CD) poses significant health risks, including an increased incidence of acute ischemic stroke (AIS). However, the specific risk factors for AIS in CD patients are not well-defined. This meta-analysis aims to identify clinically relevant risk factors for AIS in individuals with CD.

Methods

We performed a systematic review and meta-analysis by searching PubMed, Embase, Web of Science, and the Cochrane Library up to August 2024. Primary outcomes evaluated in AIS patients with CD included reduced left ventricular ejection fraction (LVEF), anticoagulation therapy, atrial fibrillation (AF), left ventricular apical aneurysm (LVAA), pacemaker use, and coronary artery disease (CAD). Risk ratios (RRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model.

Results

Six studies were included, involving 1,229 patients (48% male). The analysis revealed a higher risk of AIS in CD patients with reduced LVEF (RR 3.38; 95% CI 1.38 - 8.27), AF (OR 4.85; 95% CI 2.13 - 11.02), LVAA (OR 3.76; 95% CI 1.96 - 7.21), and pacemaker use (OR 2.37; 95% CI 1.38 - 4.09). Anticoagulation therapy was associated with a reduced likelihood of stroke (OR 0.28; 95% CI 0.19 - 0.41). No significant association was found between CAD and stroke risk (OR 1.56; 95% CI 0.93 - 2.59).

Conclusion

Reduced LVEF, AF, LVAA, and pacemaker use are correlated with higher stroke incidence in CD patients, while anticoagulation therapy diminishes this risk. Further randomized studies are needed to refine AIS prevention strategies for this population.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Current Problems in Cardiology 医学-心血管系统

CiteScore

4.80

自引率

2.40%

发文量

392

审稿时长

6 days

期刊介绍： Under the editorial leadership of noted cardiologist Dr. Hector O. Ventura, Current Problems in Cardiology provides focused, comprehensive coverage of important clinical topics in cardiology. Each monthly issues, addresses a selected clinical problem or condition, including pathophysiology, invasive and noninvasive diagnosis, drug therapy, surgical management, and rehabilitation; or explores the clinical applications of a diagnostic modality or a particular category of drugs. Critical commentary from the distinguished editorial board accompanies each monograph, providing readers with additional insights. An extensive bibliography in each issue saves hours of library research.