Effectiveness of revascularization interventions compared with medical therapy in patients with ischemic cardiomyopathy

Rezapour, Aziz; Faradonbeh, Saeed Bagheri; Alipour, Vahid; Yusefvand, Mani

doi:10.1097/md.0000000000009958

Cited by 7 publications

(8 citation statements)

References 18 publications

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“…If data is available, we also performed subgroup analyses based on region and gender to decrease heterogeneity. I 2 was also measured to assess heterogeneity between the included studies [ 17 ]. Although there was heterogeneity between the studies, this was negligible due to differences in context as well as the use of different source of data.…”

Section: Methodsmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of Stature Growth Complications in β-thalassemia Major Patients

Arab‐Zozani

Kheyrandish

Rastgar

et al. 2021

Annals of Global Health

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Background: Blood transfusion is a traditional treatment for β-thalassemia (β-thal) that improves the patients’ anemia and lifespan, but it may lead to iron overload in parenchymal tissue organs and endocrine glands that cause their dysfunctions as the iron regulatory system can’t excrete excess iron from the bloodstream. Objective: To evaluate the prevalence of iron-related complications (short stature, growth retardation, and growth hormone deficiency) in β-thalassemia major ( β TM) patients. Methods: We performed an electronic search in PubMed, Scopus, and Web of Sciences to evaluate the prevalence of growth hormone impairment in β-thalassemia major ( β TM) patients worldwide. Qualities of eligible studies were assessed by the Joanna Briggs Institute checklist for the prevalence study. We used Comprehensive Meta-Analysis (Version 2) to calculate the event rate with 95% CIs, using a random-effects model for all analyses. Findings: Seventy–four studies were included from five continents between 1978 and 2019; 70.27% (Asia), 16.21% (Europe), 6.75% (Africa), 2.70% (America), 1.35% (Oceania), and 2.70% (Multicenter). The overall mean age of the participants was about 14 years. The pooled prevalence of short stature (ST) was 48.9% (95% CI 35.3–62.6) and in male was higher than female (61.9%, 95% CI 53.4–69.7 vs. 50.9%, CI 41.8–59.9). The pooled prevalence of growth retardation (GR) was 41.1% and in male was higher than in female (51.6%, 95% CI 17.8–84 vs. 33.1%, CI 9.4–70.2). The pooled prevalence of growth hormone deficiency (GHD) was 26.6% (95% CI 16–40.8). Conclusion: Our study revealed that near half of thalassemia patients suffer from growth impairments. However, regular evaluation of serum ferritin levels, close monitoring in a proper institute, suitable and acceptable treatment methods besides regular chelation therapy could significantly reduce the patients’ complications.

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Section: Methodsmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of Stature Growth Complications in β-thalassemia Major Patients

Arab‐Zozani

Kheyrandish

Rastgar

et al. 2021

Annals of Global Health

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“…There are several methods for treating and controlling ischemic cardiomyopathy in different health systems in the world: (A) medical therapy (MT) which uses anticoagulants, such as thrombolytic, beta blocker, calcium blocker, antiarrhythmic, nitrates, diuretics, antiplatelet, and lipid regulating drugs; (B) percutaneous coronary intervention (PCI) that includes piercing the skin to access the femoral artery by a catheter, catheter-guided balloon to narrow or block the coronary artery, inflating the balloon, and dilating coronary stenting to prevent reblockage; and (C) coronary artery bypass graft (CABG) that includes a bypass with saphenous vein or arterial graft pieces of breast through open narrowed or blocked coronary sternum in place. This is a surgical technique that involves opening the chest and the tight and closed coronary artery and is usually done using a vein or artery from other parts of the body (9-10).…”

Section: Introductionmentioning

confidence: 99%

“…Thus, surgical interventions seem to become outdated, and thus their relevance to modern medical practice must be questioned (16-17). A clinical trial study compared drug therapy with surgery in patients with ischemic heart disease and found no significant evidence on the benefit of these 2 therapies in reducing mortality and morbidity (10).…”

Section: Introductionmentioning

confidence: 99%

“…Performing systematic review studies and determining the effectiveness of cardiovascular interventions play an important role in reimbursement decisions, health care pricing, providing clinical guidance on the use of existing clinical technologies, strategic purchasing of interventions, providing targeted health care, and producing scientific evidence for policy-making and, ultimately, the optimal allocation of financial resources of the health sector to cardiovascular diseases (10, 20). Thus, the aim of this study was to review and compare the effectiveness of revascularization interventions (CABG and PCI) and medical therapy in patients with ischemic cardiomyopathy.…”

Section: Introductionmentioning

confidence: 99%

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Comparing the effectiveness of revascularization interventions with medical therapy in patients with ischemic cardiomyopathy: A systematic review and meta-analysis

Faradonbeh

Azar

Rezapour

et al. 2018

Med. J. Islam. Repub. Iran

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Background: Determining the effectiveness of cardiovascular interventions plays an important role in reimbursement decisions, health care pricing, and providing clinical guidance on the use of existing clinical technologies. This study aimed to review and analyze the effectiveness of revascularization interventions (CABG and PCI) compared to medical therapy in patients with ischemic cardiomyopathy. Methods: Different databases were searched up to December 2017. The articles were selected based on inclusion and exclusion criteria. Quality of all studies was evaluated by Jadad score and relevant checklists. The I2 test was used to test heterogeneity. Also, to integrate the results of similar studies, meta-analysis was done using STATA software. Results: A total of 18 studies were included. Based on the random effects model, the overall results of comparing the effectiveness of revascularization interventions with medical therapy were as follow: 38.94 [95% CI: 26.95-50.94, p<0.001, I 2 = 99.6%, p<0.001], [75.31, 95% CI: 74.06-76.57, p<0.001, I 2 = 88.8, p<0.001], and 75.76 [95% CI: 71.99-79.53, p<0.001, I2= 99.2, p<0.001] for cardiac mortality rate, quality of life, and 5-year survival, respectively. Also, in patient satisfaction index, revascularization interventions were shown to be more effective than medical therapy. Conclusion: This study showed that revascularization interventions in all studied indices were more effective than medical therapy. Also, between revascularization interventions, PCI was more effective in cardiovascular mortality and 5-year survival than CABG in terms of quality of life. Moreover, CABG was more effective than PCI. In patient satisfaction index, the results of the 2 included studies were contradictory.

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“…Risk factors that develop ischemic heart disease are unhealthy blood cholesterol levels, hypertension, smoking, diabetes mellitus, obesity, lack of physical activity, age and so on. And complications of this disease are Chest pain, left shoulder pain, shortness of breath and weakness ( 2 , 3 ).…”

Section: Introductionmentioning

confidence: 99%

Medical therapy versus percutaneous coronary intervention in ischemic heart disease: A cost-effectiveness analysis

Rezapour

Tavakoli

Akbar

et al. 2020

mjiri

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Effectiveness of revascularization interventions compared with medical therapy in patients with ischemic cardiomyopathy

Abstract: Supplemental Digital Content is available in the text

Cited by 7 publications

References 18 publications

A Systematic Review and Meta-Analysis of Stature Growth Complications in β-thalassemia Major Patients

A Systematic Review and Meta-Analysis of Stature Growth Complications in β-thalassemia Major Patients

Comparing the effectiveness of revascularization interventions with medical therapy in patients with ischemic cardiomyopathy: A systematic review and meta-analysis

Medical therapy versus percutaneous coronary intervention in ischemic heart disease: A cost-effectiveness analysis

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