Association between obesity paradox in the all-cause mortality among patients with cardiac resynchronization therapy device.

BACKGROUND: Recent studies have demonstrated an obesity paradox, where obese patients with cardiovascular disease have a better outcome compared to those with normal weight. However, the effect of obesity and body mass index (BMI) on the outcome of patients with cardiac resynchronization therapy (CRT) devices remains unclear. The current study aims to investigate this relationship using all available published data. METHODS: We systematically reviewed studies from Medline and EMBASE databases from inception to January 2024. Eligible studies must investigate the association between BMI status and all-cause mortality in individuals with CRT devices. Relative risk (RR) or hazard ratio (HR) and 95% CIs were retrieved from each study and combined using the generic inverse variance method. RESULTS: A total of 12 cohort studies were included in the meta-analysis. Pooled analysis showed that overweight and obesity patients had lower all-cause mortality compared to those with normal body weight with the pooled risk ratios (RR) for overweight of 0.77 (95% CI 0.69-0.87, I2 47%) and for obesity of 0.81 (95% CI 0.67-0.97, I2 59%). Conversely, the underweight exhibited higher all-cause mortality than the group with normal weight, with a pooled RR of 1.37 (95% CI 1.14-1.64, I2 0%). Additionally, higher BMI as continuous data was associated with decreased all-cause mortality, with a pooled HR of 0.94 (95% CI 0.89-0.98, I2 72%). CONCLUSIONS: The pooled analyses observed an obesity paradox in patients with CRT, where overweight and obesity were associated with reduced all-cause mortality, while underweight individuals exhibited higher all-cause mortality. Further research is necessary to investigate the underlying mechanisms and their implications for clinical practice.

Association Between Chronic Hepatitis C Virus Infection and Esophageal Cancer: A Systematic Review and Meta-analysis.

BACKGROUND: Chronic hepatitis C virus (HCV) infection is associated with increased risk of hepatobiliary tract cancer. However, whether chronic HCV infection is also associated with elevated risk of other types of cancer is still unknown. This systematic review and meta-analysis was conducted in order to investigate whether chronic HCV infection is positively associated with esophageal cancer. METHODS: A systematic review was conducted using Embase and MEDLINE databases from inception to November 2019, with a search strategy that comprised the terms for "hepatitis C virus" and "cancer." Eligible studies were cohort studies consisting of patients with chronic HCV infection and comparators without HCV infection, and followed them for incident esophageal cancer. Hazard risk ratio, incidence rate ratio, relative risk or standardized incidence ratio of this association were extracted from each eligible study along with their 95% confidence intervals and were combined to calculate the pooled effect estimate using the random effect, generic inverse variance method. RESULTS: A total of 20,459 articles were identified using this search strategy. After 2 rounds of independent review, 7 studies satisfied the inclusion criteria and were included in the meta-analysis. Chronic HCV infection was significantly associated with a higher incidence of esophageal cancer with the pooled relative risk of 1.61 (95% confidence interval: 1.19-2.17; I2=39%). The funnel plot was relatively symmetric which was not suggestive of publication bias. CONCLUSION: This systematic review and meta-analysis demonstrated that there is a modest association between chronic HCV and incident esophageal cancer. However, more studies are needed to investigate the causality of this association.

EQUAL Candida score, an effective tool for predicting the outcomes of Candida tropicalis candidaemia: A retrospective cohort study.

BACKGROUND: Candida tropicalis is the most common non-albicans Candida species found in Asia-Pacific countries, including Thailand. The pathogen is known for its great virulence, which causes a high case-fatality rate. Associations between case fatality and patient characteristics, infectious disease unit consultation and EQUAL Candida score were investigated. METHODS: This retrospective cohort study was conducted with 160 cases of C. tropicalis bloodstream infection between 2015 and 2019 at a single, large, tertiary centre in Thailand. Clinical characteristics, clinical presentations, patient outcomes (30-day case-fatality rate) and independent predictive factors were analysed. RESULTS: The 30-day case-fatality rate was 68.1%. The median of the EQUAL Candida score was 8. Independent factors for the prediction of case fatality were septic shock (hazard ratio, 1.84), the use of mechanical ventilation (hazard ratio, 2.03) and the EQUAL Candida score (hazard ratio, 0.75). CONCLUSIONS: The predictive factors for 30-day case fatality were septic shock, mechanical ventilation use and the EQUAL Candida score. It is recommended that the EQUAL score be considered for patients infected with C. tropicalis candidaemia to reduce the case-fatality rate.

Successful treatment of arrhythmia with ß-blocker and flecainide combination in pregnant patients with Andersen-Tawil syndrome: A case report and literature review.

Andersen-Tawil syndrome (ATS) is a rare disorder characterized by a triad of ventricular arrhythmia (VA), dysmorphic features, and periodic paralysis. Due to the rarity of this condition, less is known about physiologic effect of pregnancy to ATS and arrhythmia. There is no established guideline for peripartum or postpartum treatment and prevention of arrhythmia in ATS; thus, the clinical management is challenging. We reported two KCNJ2-associated ATS patients who got pregnant and underwent vaginal birth safely. Both individuals had VA, micrognathia without periodic paralysis. ß-blocker plus flecainide could be an effective treatment combination when monotherapy failed to control arrhythmia. VA of two pregnant patients with ATS could be controlled by either physiologic changes associated pregnancy or the combination treatment of ß-blocker and flecainide.

Effectiveness and Safety of a Single 7-French Plastic Stent for Endoscopic Ultrasound-guided Pancreatic Pseudocyst Drainage and Long-term Follow-up Outcomes.

BACKGROUND: Endoscopic ultrasound (EUS)-guided cystogastrostomy with a single 7-French (Fr) double-pigtail stent (DPS) is less popular due to the concern of stent patency. We aimed to assess the effectiveness, complications, and long-term outcomes of a single 7-Fr DPS in the endoscopic drainage of uncomplicated pseudocysts, containing no or minimal (<10%) debris. METHODS: A retrospective review of patients with pancreatic pseudocysts, who underwent EUS-guided cystogastrostomy during 2010-2018, and a systematic review of the literature were conducted. RESULTS: Of 45 patients, 14 patients underwent endoscopic drainage of uncomplicated pseudocysts using a single 7-Fr × 5 cm DPS. The mean cyst size was 10.2 ± 3.5 cm. Stent placement had a 100% technical and clinical success, defined as complete resolution of symptoms and regression of the cyst size by more than 50% at 8 weeks after drainage. The median follow-up was 42.4 months (range, 10-103). The pseudocysts resolved without recurrence in 92.8%. Spontaneous stent dislodgment was noted in 70% at a mean follow-up of 18 months. Additional interventions were required in 14% of cases due to stent occlusion and migration. A systematic review of literature related to EUS-guided cystogastrostomy using single and multiple plastic stents included 9 of 333 studies (222 patients). The analysis showed the pooled clinical success of 89% (95% confidence interval [CI], 82.0-94.2) and complication rate of 13% (95% CI, 5.7-21.8). CONCLUSION: Selected uncomplicated pseudocysts can be treated effectively with a single 7-Fr DPS as it provides comparable clinical success and long-term outcomes as using larger or multiple stents.

Triple infection with Cryptococcus, varicella-zoster virus, and Mycobacterium abscessus in a patient with anti-interferon-gamma autoantibodies: a case report.

BACKGROUND: The most common infection in patients positive for anti-interferon-gamma autoantibodies (anti-IFN-γ AAbs) is disseminated nontuberculous mycobacterial (dNTM) infection. Here, we report a rare case of triple infection caused by Cryptococcus, varicella-zoster virus (VZV), and nontuberculous mycobacterium in a patient with anti-IFN-γ AAbs. CASE PRESENTATION: A 53-year-old Thai man presented with a progressively enlarging right cervical mass with low-grade fever and significant weight loss for 4 months. He also developed a lesion at his left index finger. A biopsy of that lesion showed granulomatous inflammation with yeast-like organisms morphologically consistent with cryptococcosis. Serum cryptococcal antigen was positive. Histopathology of a right cervical lymph node revealed chronic granulomatous lymphadenitis, and the lymph node culture grew Mycobacterium abscessus. One month later, he complained of vision loss in his left eye and subsequently developed a group of painful vesicles at the right popliteal area of S1 dermatome. Lumbar puncture was performed and his cerebrospinal fluid was positive for VZV DNA. His blood test for anti-HIV antibody was negative. Anti-IFN-γ AAbs was positive, but test for anti-granulocyte-macrophage colony-stimulating factor autoantibodies (anti-GM-CSF AAbs) was negative. He was treated with amphotericin B plus fluconazole for cryptococcosis; a combination of amikacin, imipenem, azithromycin, and levofloxacin for dNTM infection; and, intravenous acyclovir for disseminated VZV infection. After treatment, our patient's fever and cervical lymphadenopathy were subsided, and his vision and visual acuity were both improved. CONCLUSIONS: This is the first case of triple infection with cryptococcosis, VZV, and dNTM in a patient who tested positive for anti-IFN-γ AAbs and negative for anti-GM-CSF AAbs. This case will increase awareness and heighten suspicion of these infections in patients with the described presentations and clinical characteristics, and this will accelerate diagnosis and treatment.

Chronic Hepatitis C Virus Infection is Associated with an Increased Risk of Lung Cancer: A Systematic Review and Meta-analysis.

BACKGROUND: Chronic hepatitis C virus (HCV) infection is associated with increased risk of hepatocellular carcinoma. However, whether HCV infection also increases the risk of extra-hepatic cancer is still not well-established. This systematic review and meta-analysis was conducted in order to investigate the relationship between chronic HCV infection and lung cancer. MATERIALS AND METHODS: A systematic review was performed using MEDLINE and EMBASE databases from inception to November 2019 with search strategy that included the terms for "hepatitis C virus" and "cancer". Eligible studies must be cohort studies that included patients with chronic HCV infection and comparators without HCV infection, then followed them for incident lung cancer. Relative risk, incidence rate ratio, standardized incidence ratio or hazard risk ratio of this association along with associated 95% confidence interval (CI) were extracted from each eligible study and combined for the calculation of the pooled effect estimate using the random effect, generic inverse variance method. RESULTS: A total of 20,459 articles were identified using the aforementioned search strategy. After two rounds of review, eight studies fulfilled the inclusion criteria and were included into the meta-analysis. Chronic HCV infection was significantly associated with an increased risk of lung cancer with the pooled relative risk of 1.94 (95% CI 1.56-2.42; I2 = 87%). Funnel plot was fairly symmetric and not suggestive of presence of publication bias. CONCLUSIONS: The current study demonstrated that chronic HCV infection is significantly associated with a 1.94-fold increased risk of developing lung cancer. However, further studies are still needed to investigate if this association is causative.

Risk of Stroke among Patients with Chronic Rhinosinusitis: A Systematic Review and Meta-analysis.

BACKGROUND: Recent studies have suggested that patients with chronic rhinosinusitis (CRS) may have a higher risk of stroke although the data are still limited. The current systematic review and meta-analysis was conducted with the aims to identify all studies that investigated this relationship and summarize their results together to better characterize the risk of stroke among patients with CRS. METHODS: A comprehensive literature review was conducted by searching for published articles in MEDLINE and EMBASE databases from inception to October 2018 to identify all observational studies that compared the risk of stroke among patients with CRS to individuals without CRS. Pooled risk ratio (RR) and 95% confidence interval (CI) were calculated using random-effect, generic inverse variance method of DerSimonian and Laird. RESULTS: A total of 5 studies with 447,065 participants met the eligibility criteria and were included into the meta-analysis. The risk of stroke among patients with CRS was significantly higher than individuals without CRS with the pooled RR of 1.79 (95% CI, 1.34-2.40, I2 = 84%). CONCLUSIONS: The current study found that CRS is associated with higher risk stroke. Whether this relationship is causal and how it should be addressed in clinical practice require further investigations.

Impact of COVID-19 infection among patients hospitalized for conventional pacemaker implantation: Analysis of the Nationwide Inpatient Sample (NIS) 2020.

Introduction: The cardiac pacemaker is indicated for treating various types of bradyarrhythmia, providing lifelong cardiovascular benefits. Recent data showed that COVID-19 has impacted procedure numbers and led to adverse long-term outcomes in patients with cardiac pacemakers. However, the impact of COVID-19 infection on the in-hospital outcome of patients undergoing conventional pacemaker implantation remains unclear. Method: Patients aged above 18 years who were hospitalized for conventional pacemaker implantation in the Nationwide In-patient Sample (NIS) 2020 were identified using relevant ICD-10 CM and PCS codes. Multivariable logistic and linear regression models were used to analyze pre-specified outcomes, with the primary outcome being in-patient mortality and secondary outcomes including system-based and procedure-related complications. Results: Of 108 020 patients hospitalized for conventional pacemaker implantation, 0.71% (765 out of 108 020) had a concurrent diagnosis of COVID-19 infection. Individuals with COVID-19 infection exhibited a lower mean age (73.7 years vs. 75.9 years, p = .027) and a lower female proportion (39.87% vs. 47.60%, p = .062) than those without COVID-19. In the multivariable logistic and linear regression models, adjusted for patient and hospital factors, COVID-19 infection was associated with higher in-hospital mortality (aOR 4.67; 95% CI 2.02 to 10.27, p < .001), extended length of stay (5.23 days vs. 1.04 days, p < .001), and linked with various in-hospital complications, including sepsis, acute respiratory failure, post-procedural pneumothorax, and venous thromboembolism. Conclusion: Our study suggests that COVID-19 infection is attributed to higher in-hospital mortality, extended hospital stays, and increased adverse in-hospital outcomes in patients undergoing conventional pacemaker implantation.

Impact of COVID-19 infection on the in-hospital outcome of patients hospitalized for heart failure with comorbid atrial fibrillation: Insight from the National Inpatient Sample (NIS) database 2020.

Introduction: Atrial fibrillation (AF) and heart failure (HF) commonly coexist, resulting in adverse health and economic consequences such as declining ventricular function, heightened mortality, and reduced quality of life. However, limited information exists on the impact of COVID-19 on AF patients that hospitalized for HF. Methods: We analyzed the 2020 U.S. National Inpatient Sample to investigate the effects of COVID-19 on AF patients that primarily hospitalized for HF. Participants aged 18 and above were identified using relevant ICD-10 CM codes. Adjusted odds ratios for outcomes were calculated through multivariable logistic regression. The primary outcome was inpatient mortality, with secondary outcomes including system-based complications. Results: We identified 322,090 patients with primary discharge diagnosis of HF with comorbid AF. Among them, 0.73% (2355/322,090) also had a concurrent diagnosis of COVID-19. In a survey multivariable logistic and linear regression model adjusting for patient and hospital factors, COVID-19 infection was associated with higher in-hospital mortality (aOR 3.17; 95% CI 2.25, 4.47, p < 0.001), prolonged length of stay (ß LOS 2.82; 95% CI 1.71, 3.93, p < 0.001), acute myocarditis (aOR 6.64; 95% CI 1.45, 30.45, p 0.015), acute kidney injury (AKI) (aOR 1.48; 95% CI 1.21, 1.82, p < 0.001), acute respiratory failure (aOR 1.24; 95% CI 1.01, 1.52, p 0.045), and mechanical ventilation (aOR 2.00; 95% CI 1.28, 3.13, p 0.002). Conclusion: Our study revealed that COVID-19 is linked to higher in-hospital mortality and increased adverse outcomes in AF patients hospitalized for HF.

Risk of atrial fibrillation among patients with premature ventricular complexes: a systematic review and meta-analysis of cohort studies.

INTRODUCTION: Atrial fibrillation (AF) is more likely found in patients with premature ventricular complexes (PVCs). Nonetheless, the outcomes of previous investigations remain inconclusive. To evaluate the link between PVCs and the risk of AF, we did a systematic review and meta-analysis. EVIDENCE ACQUISITION: Potentially eligible studies were found by searching for published publications indexed in the MEDLINE and EMBASE databases from inception to April 13, 2021, looking for studies that assessed the risk of AF in patients with PVCs vs. those who did not have PVCs. Dersimonian and Laird's random-effect, generic inverse variance technique was used to calculate the pooled risk ratio (RR) and 95% confidence interval (CI). EVIDENCE SYNTHESIS: The meta-analysis includes 6 cohort studies (1 prospective and 5 retrospective cohort studies) with a total of 9,662,088 individuals. We found that patients with PVCs have a significantly higher risk of AF than individuals without PVCs with the pooled RR of 1.90 (95% CI: 1.51-2.39, I2=83%). CONCLUSIONS: PVCs are significantly related with a 1.90-fold higher incidence of AF, according to the present systematic review and meta-analysis. Nonetheless, further research is needed to determine how this connection should be treated in clinical practice if it is causal.

Incidence of postoperative, major, adverse cardiac events in patients undergoing carotid endarterectomy: A single-center, retrospective study.

OBJECTIVE: This study aimed to determine the incidence of postoperative major adverse cardiac events for patients undergoing carotid endarterectomy. METHODS: This single-center, retrospective study recruited 171 carotid endarterectomy patients between January 1999 and June 2018. Patients who received a carotid endarterectomy in conjunction with other surgery were excluded. The primary outcomes were the incidences of major adverse cardiac events (comprising myocardial infarction, significant arrhythmias, congestive heart failure, and cardiac death) within 7 days, 7-30 days, and > 30 days-1 year, postoperatively. The secondary outcomes were the factors related to major adverse cardiac events and the incidence of postoperative stroke. The patients' charts were reviewed, and direct contact was made with them to obtain information on their status post discharge. RESULTS: The incidences of major adverse cardiac events within 7 days, 7-30 days, and >30 days-1 year of the carotid endarterectomy were 3.5% of patients (95% confidence interval: 0.008-0.063), 1.2% (95% confidence interval: 0.004-0.028), and 1.8% (95% confidence interval: 0.002-0.037), respectively. The major adverse cardiac events occurring within 7 days were arrhythmia (2.3% of patients), cardiac arrest (1.8%), myocardial infarction (1.2%), and congestive heart failure (1.2%), while the corresponding postoperative stroke rate was 4.7%. CONCLUSION: The 7-day incidence of major adverse cardiac events after the carotid endarterectomy was 3.5%. The most common major adverse cardiac event during that period was cardiac arrhythmia.

1,25-dihydroxyvitamin D-mediated hypercalcemia associated with solid organ malignancy: a systematic review.

BACKGROUND: A growing amount of evidence has suggested that 1,25-dihydroxyvitamin D [1,25(OH)2D]-mediated hypercalcemia can be found not only in lymphoma and granulomatous disorders, but also in solid organ malignancies. Using systematic review technique, we aimed to summarize all available evidence of possible 1,25(OH)2D-mediated hypercalcemia in patients with solid organ malignancies. METHODS: Potentially eligible articles were identified from MEDLINE and EMBASE databases from inception to December 2020 using search strategy consisting of terms related to "Vitamin D", "Hypercalcemia" and "Malignancy". Eligible article must be either case report or case series that reports individual level data of a patient or patients with hypercalcemia associated with solid organ malignancy and elevated 1,25(OH)2D without concomitant conditions that may otherwise explain 1,25(OH)2D-mediated hypercalcemia. Characteristics of the patients were extracted from each study. Eligible cases were categorized into three groups, including "definite", "probable" and "possible" cases, using the criteria to assess the strength of evidence that hypercalcemia observed in the eligible cases was caused by the presence of tumor that resulted in the increased production of 1,25(OH)2D. RESULTS: A total of 1,673 articles were identified. After systematic review, 17 articles reporting 17 patients with 11 different types of solid organ malignancies associated with hypercalcemia secondary to elevated 1,25(OH)2D were identified. Based on the criteria to assess the strength of evidence of hypercalcemia mediated by tumor-associated increased production of 1,25(OH)2D, there were 4 definite cases and 13 probable cases. CONCLUSIONS: This systematic review of case reports and case series revealed 17 patients with 11 different types of solid organ malignancies associated with hypercalcemia and elevated 1,25(OH)2D.

The association between allergic rhinitis and risk of rheumatoid arthritis: A systematic review and meta-analysis.

OBJECTIVE: To investigate the association between allergic rhinitis (AR) and the risk of rheumatoid arthritis (RA). METHODS: Potentially eligible studies were identified from MEDLINE and EMBASE databases from inception to November 2019. Eligible cohort study must report relative risk with 95% confidence intervals (95% CIs) of incident RA between AR patients and comparators. Eligible case-control studies must include cases with RA and controls without RA, and must explore their history of AR. Odds ratio with 95% CIs of the association between AR and RA must be reported. Point estimates with standard errors from each study were combined using the generic inverse variance method. RESULTS: A total of 21,824 articles were identified. After two rounds of the independent review by three investigators, two cohort studies and 10 case-control studies met the eligibility criteria. The pooled analysis showed no association between AR and risk of RA (RR = 0.94; 95% CI, 0.73 to 1.20; I2   = 84%). However, when we conducted a sensitivity analysis including only studies with acceptable quality, defined as Newcastle-Ottawa score of seven or higher, we found that patients with AR had a significantly higher risk of RA (RR = 1.36; 95% CI, 1.12 to 1.65; I2  = 45%). CONCLUSIONS: The current systematic review and meta-analysis could not reveal a significant association between AR and RA. However, when only studies with acceptable quality were included, a significantly higher risk of RA among patients with AR than individuals without AR was observed.

Association of premature ventricular complexes and risk of ischemic stroke: A systematic review and meta-analysis.

Recent studies have suggested that patients with premature ventricular complexes (PVCs) may have a higher risk of ischemic stroke. However, the data are limited and inconclusive. We conducted a systematic review and meta-analysis to investigate the association between PVCs and the risk of ischemic stroke. A comprehensive literature review was conducted by searching for published articles indexed in MEDLINE and EMBASE databases from inception through September 25, 2020, to identify studies that compared the risk of ischemic stroke between patients with PVCs and individuals without PVCs. Pooled risk ratio (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method of Dersimonian and Laird. A total of four observational studies (2 prospective and 2 retrospective cohort studies) with 42 677 participants met the eligibility criteria and were included in the meta-analysis. We found that patients with PVCs have a significantly higher risk of ischemic stroke than individuals without PVCs with the pooled RR of 1.31 (95% CI, 1.07-1.60, I2 = 43%). From our systematic review and meta-analysis, we found that PVCs are associated with a higher risk of ischemic stroke. Whether this association is causal and how it should be addressed in clinical practice require further investigations.

Immediate aortic dissection after transcatheter aortic valve replacement: A case report and review of the literature.

-Aortic dissection of descending aorta was detected by intraoperative TEE in a case of 67-year-old man with symptomatic severe aortic stenosis after TAVR. -Transesophageal echocardiogram after TAVR procedure is helpful to detect this rare complication.

Atopic Dermatitis is a Risk Factor for Rheumatoid Arthritis: A Systematic Review and Meta-Analysis.

BACKGROUND: It is still unclear whether patients with atopic dermatitis (AD) have an increased risk of developing rheumatoid arthritis (RA). OBJECTIVE: We aimed to investigate the association between AD and risk of RA using systematic review and meta-analysis. METHODS: We searched Medline and EMBASE up to April 2021 using search strategy, including terms for "atopic dermatitis" and "rheumatoid arthritis." Eligible cohort study must compare the incidence of RA between patients with AD and comparators without AD. Eligible case-control study must recruit cases with RA and controls without RA. Then, the study must compare the prevalence of AD between the groups. Point estimates with standard errors from each study were combined using the generic inverse variance method. RESULTS: The meta-analysis found that AD patients had a significantly higher risk of incident RA than individuals without AD with a pooled odds ratio (OR) of 1.30 (95% confidence interval [CI], 1.17-1.44; I2, 48%). Subgroup analysis revealed a significantly higher risk of RA in cohort study subgroup (pooled OR, 1.37; 95% CI, 1.25-1.50; I2, 63%) but not case-control study subgroup (pooled OR, 0.99; 95% CI, 0.77-1.28; I2, 10%). CONCLUSIONS: This study found a significantly higher risk of incident RA among AD patients.

Chronic obstructive pulmonary disease (COPD) is associated with a higher level of serum uric acid. A systematic review and meta-analysis.

INTRODUCTION: Recent studies have suggested that patients with chronic obstructive pulmonary disease (COPD) may have a higher level of serum uric acid compared with individuals without COPD, although the data are still limited. The current systematic review and meta-analysis was conducted to summarize all available data. MATERIAL AND METHODS: A systematic review was performed using the MEDLINE and EMBASE databases from their inception to July 2019. Studies that were eligible for the meta-analysis must have consisted of two groups of participants, patients with COPD and individuals without COPD. The eligible studies must have reported either mean or median level of serum uric acid and its standard deviation (SD) or interquartile range of participants in both groups. Mean serum uric acid level and SD of participants in both groups were extracted from each study and the mean difference (MD) was calculated. Pooled MD was then computed by combining MDs of each study using random effects model. RESULTS: A total of eight studies with 1,612 participants met the eligibility criteria and were included in the data analysis. The serum uric acid level among patients with COPD was significantly higher than individuals without COPD with the pooled MD of 0.91 mg/dL (95% CI: 0.45-1.38; I2 = 89%). CONCLUSIONS: The current study found a significantly higher level of serum uric acid among patients with COPD than individuals without COPD.

Prevalence of atrial arrhythmia in patients with arrhythmogenic right ventricular cardiomyopathy: a systematic review and meta-analysis.

BACKGROUND/OBJECTIVES: Little is known about atrial involvement in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). Recent studies have suggested that atrial arrhythmia, including atrial fibrillation, atrial flutter (AFL), and atrial tachycardia, was common among these patients although the reported prevalence varied considerably across the studies. The current systematic review and meta-analysis was conducted with the aim of comprehensively investigating the prevalence of overall atrial arrhythmia and each atrial arrhythmia subtype in the setting of ARVC by identifying all relevant studies and combining their results together. METHODS: A comprehensive literature review was conducted by searching for published articles indexed in MEDLINE and EMBASE databases from inception through to 22 September 2019 to identify cohort studies of patients with ARVC that described the prevalence of atrial arrhythmia among the participants. The pooled prevalence across studies was calculated using a random-effect, generic inverse variance method of DerSimonian and Laird with a double arcsine transformation. RESULTS: A total of 16 cohort studies with 1986 patients with ARVC were included in this meta-analysis. The pooled prevalence of overall atrial arrhythmia among patients with ARVC was 17.9% [95% confidence interval (CI), 13.0-24.0%; I 88%], the pooled prevalence of atrial fibrillation of 12.9% (95% CI, 9.6-17.0%; I 78%), the pooled prevalence of AFL of 5.9% (95% CI, 3.7-9.2%; I 70%), and the pooled prevalence of atrial tachycardia of 7.1% (95% CI, 3.7-13.0%; I 49%). CONCLUSION: Atrial arrhythmia is common among patients with ARVC with the pooled prevalence of approximately 18%, which is substantially higher than the reported prevalence of atrial arrhythmia in the general population.