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
The aim of this meta-analysis was to assess the safety and efficacy of warfarin plus aspirin versus warfarin monotherapy in patients with left ventricular assist devices (LVAD). The present meta-analysis was conducted using the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two authors systematically searched online databases, including PubMed, EMBASE, the Cochrane Library, and Web of Science from inception to December 31, 2023. Outcomes assessed in this meta-analysis included any thrombotic event, bleeding events, and all-cause mortality. A total of five articles were included in the meta-analysis, enrolling a pooled sample size of 876 patients, including 405 in the warfarin monotherapy group and 471 in the warfarin plus aspirin group. Pooled analysis showed that the risk of thrombotic events was not significantly different between the two groups (risk ratio (RR): 0.46, 95% confidence interval (CI): 0.15-1.37). The risk of bleeding events was significantly lower in patients receiving warfarin alone compared to patients receiving aspirin plus warfarin (RR: 0.67, 95% CI: 0.53-0.85). The risk of all-cause mortality was not significantly different between patients receiving warfarin alone and patients receiving aspirin plus warfarin (RR: 0.92, 95% CI: 0.65-1.30). Despite the potential benefits of discontinuing aspirin, the decision should be approached cautiously, considering the undefined risks of discontinuing anticoagulation in LVAD patients.
