Background The efficacy of statins in the prevention and treatment of cardiovascular disease is well established. Despite their large benefit, statin intolerance (SI) is still an important clinical challenge. In this meta-analysis, we aimed to estimate the overall prevalence of SI, the prevalence based on different diagnostic criteria and different disease settings. Methods We searched all electronic databases until the end of March 2021 for studies that reported the prevalence of SI. The primary endpoint was overall prevalence and prevalence based on different diagnostic criteria (National Lipid Association/NLA, International Lipid Expert Panel/ILEP and European Atherosclerosis Society/EAS). The secondary endpoint was the SI prevalence in the groups of patients with different diseases' settings. A random-effects model was applied to estimate the overall pooled prevalence. Results One hundred and seventy-six studies (112 RCTs; 64 cohort studies) with 4,143,517 patients were included in the analysis. The overall SI prevalence was 9.1% (8.1 to 10%). The prevalence based on NLA criteria was similar compared to ILEP and EAS (7.0, 6.7, 5.9%, respectively; p>0.05). The prevalence of SI in RCTs studies was significantly lower in comparison to the cohort studies (4.9 vs. 17%; p<0.001). The SI prevalence in patients both in primary and secondary prevention was much higher (18%; mainly due to dominant cohort studies) than in the separate analysis of those in primary and secondary prevention (8.2, 9.1%, respectively; p<0.05). In the subgroup analysis based on different disease in the primary prevention: familial hypercholesterolemia, hypercholesterolemia, dyslipidemia and diabetes mellites, the prevalence was 9, 12, 13 and 6%, respectively) and in the secondary prevention: stable coronary artery disease, acute coronary syndrome and myocardial infarction – 8, 13, and 13%; respectively (Figure 1). Conclusions Based on the data from analysis of over 4 million patients, the overall SI prevalence is low, and even lower based on the recognized international definitions. These results support the concept that complete intolerance might be often overestimated and highlight the need for very careful examination of patients with statin intolerance. Funding Acknowledgement Type of funding sources: None. Figure 1. Prevalence of statin intolerance
Purpose: To evaluate the impact of different intraocular tamponades on the vision-related quality of life (VRQOL) after idiopathic epiretinal membrane (IEM) surgery with epiretinal membrane peeling. Methods: We prospectively enrolled 50 patients diagnosed with IEM who underwent pars plana vitrectomy. Patients were consecutively assigned to either the air tamponade (air) group (25 patients) or the balanced salt solution (BSS) tamponade group (25 patients). The following data were collected before and after surgery and compared between the two groups: VRQOL, best-corrected visual acuity, intraocular pressure, metamorphopsia, contrast sensitivity, and central macular thickness. Results: Pars plana vitrectomy was performed in 50 eyes. At baseline, there were no significant differences between the two groups. At 6 months postoperatively, VRQOL (P < 0.001), best-corrected visual acuity (P < 0.001), central macular thickness (P < 0.001), contrast sensitivity (P < 0.001), and metamorphopsia (P < 0.001) improved significantly in comparison with baseline, without significant differences between the air tamponade and BSS groups. Conclusion: Removing IEM significantly improved visual function and VRQOL. Despite improvements, this study showed no difference postoperatively whether air or BSS tamponade was used during surgery. As a result, air tamponade may not be a mandatory treatment for IEM surgery and provides no additional advantage compared with BSS tamponade.
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