RESUMO
The aim of this meta-analysis was to scrutinize the prevalence, characteristics, and outcomes of obstructive sleep apnea (OSA) in individuals with ideopathic pulmonary fibrosis (IPF). We carried out this systematic review and meta-analysis in accordance with the guidelines outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Statement (PRISMA). Two independent researchers systematically searched major databases, including MEDLINE/PubMed, EMBASE, and the Cochrane Library, from January 1, 2000, until December 31, 2023. We included all studies involving adult patients (age >18 years) with IPF that assessed the prevalence and characteristics of OSA in IPF patients. A total of seven studies involving a pooled sample of 411 patients were included in this meta-analysis. The pooled prevalence of OSA among individuals with IPF was found to be 70% (95% CI: 59 to 82%). Individuals with OSA exhibited a significantly higher mean body mass index (BMI) compared to their counterparts. While individuals with both IPF and OSA exhibited higher scores on the Epworth Sleepiness Scale (ESS) compared to those with IPF alone, the OSA group also showed lower oxygen saturation during sleep in comparison to non-OSA patients. In summary, OSA is a prevalent coexisting condition among individuals with IPF. This presence could worsen the nighttime oxygen saturation. Consequently, there is a need for more extensive studies involving more uniform participant groups.
RESUMO
Patients with acute myocardial infarction (AMI) are usually treated with angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARB). The aim of this meta-analysis is to compare outcomes between ACEi and ARB in patients with myocardial infarction (MI). This meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Three major online databases, including PubMed, EMBASE, and the Cochrane Library, were thoroughly searched to find studies comparing ACEi and ARB in patients with MI from January 1, 2000, onwards, without language or publication restrictions. Outcomes assessed in this meta-analysis included major adverse cardiovascular events (MACE), all-cause mortality, cardiovascular mortality, stroke, and hospitalization due to heart failure. A total of 16 studies were included in this meta-analysis. Pooled estimates showed no significant differences between the two groups in terms of MACE (risk ratio (RR): 1.03, 95% confidence interval (CI): 0.88-1.20), all-cause mortality (RR: 1.03, 95% CI: 0.88-1.20), cardiovascular mortality (RR: 1.00, 95% CI: 0.89-1.12), stroke (RR: 1.03, 95% CI: 0.80-1.32), and hospitalization due to heart failure (RR: 0.99, 95% CI: 0.90-1.09). These results suggest that ACEi and ARB have similar impacts on clinical outcomes across a broad spectrum of MI patients, reinforcing their roles in post-MI treatment.
RESUMO
The objective of this study was to determine predictors of postoperative atrial fibrillation (POAF) among coronary artery bypass graft (CABG) patients. This meta-analysis was conducted as per the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Two authors performed searches independently using electronic databases, including Embase, PubMed, and Web of Science, from January 1, 2015, to November 30, 2023. A total of 16 studies were included in this meta-analysis. All included studies reported POAF in patients undergoing CABG, resulting in 1462 cases of POAF among 6200 patients undergoing CABG. The cases of POAF varied among studies, ranging from 7.80% to 47.37%. The pooled incidence of POAF was 26% (95% CI: 20% to 31%). The results indicated that older patients had a higher risk of developing atrial fibrillation (AF) after CABG (mean difference [MD]): 5.63, 95% confidence interval (CI): 4.08 to 7.17, p-value < 0.001). The findings revealed a significantly lower left ventricular ejection fraction (LVEF) in patients developing AF than their counterparts (MD: -0.30, 95% CI: -0.58 to -0.03, p-value: 0.03). Regarding the history of myocardial infarction (MI), the odds of MI were significantly higher in patients developing AF compared to those who did not develop AF (odds ratio [OR]: 1.37, 95% CI: 1.12 to 1.68, p-value: 0.002). In relation to intra-aortic balloon pump (IABP), the odds of IABP were significantly higher in patients developing AF compared to those who did not develop AF (OR: 2.27, 95% CI: 1.39 to 3.72, p-value: 0.001). Identified risk factors for post-CABG AF included advanced age, a lower preoperative ejection fraction, a history of myocardial infarction, the requirement for an IABP, and prolonged cardiopulmonary bypass (CPB) time. The study underscores the significance of proactive screening and comprehensive management for elderly CABG patients, particularly those with myocardial infarction histories.
