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Background: The potential benefits of individualized guided selection of antiplatelet therapy over standard antiplatelet therapy in improving outcomes in patients undergoing percutaneous coronary intervention (PCI) have not been established. Therefore, we pooled evidence from available clinical trials to assess the effectiveness by comparing the two regimens in patients undergoing PCI. Methods: We queried two electronic databases, MEDLINE and Cochrane CENTRAL, from their inception to April 20, 2021 for published randomized controlled trials in any language that compared guided antiplatelet therapy, using either genetic testing or platelet function testing, versus standard antiplatelet therapy in patients undergoing PCI. The results from trials were presented as risk ratios (RRs) with 95% confidence intervals (CIs) and were pooled using a random-effects model. Results: Eleven eligible studies consisting of 18,465 patients undergoing PCI were included. Pooled results indicated that guided antiplatelet therapy, compared to standard therapy, was associated with a significant reduction in the incidence of MACE [RR 0·78, 95% CI (0·62-0·99), P = 0·04], MI [RR 0·73, 95% CI (0·56-0.96), P = 0·03], ST [RR 0·66, 95% CI (0·47-0.94), P = 0·02], stroke [RR 0·71, 95% CI (0·50-1.00), P = 0·05], and minor bleeding [RR 0·78, 95% CI (0·66-0.91), P = 0·003]. Conclusions: Individualized guided selection of antiplatelet therapy significantly reduced the incidence of MACE, MI, ST, stroke, and minor bleeding in adult patients when compared with standard antiplatelet therapy. Our findings support the implementation of genetic and platelet function testing to select the most beneficial antiplatelet agent.
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BACKGROUND: Dietetics today occupy a significant place in the field of research, helping to discover cardiovascular benefits of healthy diets and consumption of organic foods such as fruits, vegetables, legumes, nuts, and whole grains. One of the components of vegetable-based diet is chili pepper (CP) which has been found to affect all-cause mortality. METHODS: MEDLINE, EMBASE, Scopus, EBSCO, and Cochrane (Wiley) Central Register of Controlled Trials were searched from inception till January 9, 2020, identifying all relevant studies using keywords and truncations. Studies were included if (1) they were observational or randomized in nature (2) included patients consuming CP and (3) evaluated direct comparison between regular and rarely/never CP consumption. RESULTS: Our preliminary search yielded 6976 articles. Post exclusion and after full-text screening, four potential observational studies with a population of 570,762. Pooled analysis found reduced all-cause mortality in CP consumers compared to nonconsumers with a risk ratio (RR) of 0.75 [95% CI: 0.64-0.88; p = 0.0004; I 2 = 97%]. The RR for CVD, cancer related and CVA deaths were 0.74 [95% CI: 0.62-0.88; p = 0.0006, I 2 = 66%], 0.77 [95% CI: 0.71-0.84; p = 0.0001; I 2 = 49%] and 0.76 [95% CI: 0.36-1.60; p = 0.47; I2 = 93%], respectively. CONCLUSION: Statistically significant results of our analysis put forward a rationale indicating an association between lower risk of all-cause, cardiovascular and cancer related deaths and CP consumption.
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BACKGROUND: The effectiveness of oral and intravenous iron supplementation in reducing the risk of mortality and hospitalizations in HF patients with iron deficiency is not well-established. METHODS: A thorough literature search was conducted across 2 electronic databases (Medline and Cochrane Central) from inception through March 2021. RCTs assessing the impact of iron supplementation on clinical outcomes in iron deficient HF patients were considered for inclusion. Primary end-points included all-cause mortality and HF hospitalization. Evaluations were reported as odds ratios (ORs) or risk ratios (RRs) with 95% confidence intervals (CI) and analysis was performed using a random effects model. I2 index was used to assess heterogeneity. RESULTS: From the 2599 articles retrieved from initial search, 10 potentially relevant studies (n = 2187 patients) were included in the final analysis. Both oral (OR: 0.93; 95% CI: 0.08-11.30; p = 0.951) and intravenous (OR: 0.97; 95% CI: 0.73-1.29; p = 0.840) iron supplementation did not significantly reduce all-cause mortality. However, intravenous iron supplementation significantly decreased the rates of overall (OR: 0.52; 95% CI: 0.33-0.81; p = 0.004) and HF (OR: 0.42; 95% CI: 0.22-0.80; p = 0.009) hospitalizations. In addition, intravenous ferric carboxymaltose therapy significantly reduced the time to first HF hospitalization or cardiovascular mortality (RR = 0.70; 95% CI = 0.50-1.00; p = 0.048), but had no effect on time to first cardiovascular death (RR: 0.94; 95% CI: 0.70-1.25; p = 0.655). CONCLUSION: Oral or intravenous iron supplementation did not reduce mortality in iron deficient HF patients. However, intravenous iron supplementation was associated with a significant decrease in overall and HF hospitalizations.