Racial Disparity Among the Clinical Outcomes Post-Myocardial Infarction Patients: A Systematic Review and Meta-analysis

Jaiswal, Vikash; Hanif, Muhammad Abdullah; Ang, Song Peng; Mehta, Aashna; Ishak, Angela; Song, David; Daneshvar, Farshid; Butey, Swatika; Gera, Asmita; Aujla, Savvy; Raj, Nishchita; Iqbal, Abbas; Kumar, Vikas; Huang, Helen; Mukherjee, Dattatreya; Jaiswal, Akash; Wajid, Zarghoona

doi:10.1016/j.cpcardiol.2022.101528

Cited by 10 publications

(10 citation statements)

References 20 publications

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“…This systematic review was conducted and reported following the Cochrane and PRISMA (Preferred Reporting Items for Systematic Review and Meta-analysis) (Supplemental Digital Content 1, http://links.lww.com/JS9/B798 , Supplemental Digital Content 2, http://links.lww.com/JS9/B799 ) 2020 guidelines as described previously 7 – 9 . A prespecified study protocol has been registered in the PROSPERO.…”

Section: Methodsmentioning

confidence: 99%

Vascular complications and outcomes following transcatheter aortic valve replacement in patients on chronic steroid therapy: a meta-analysis

Ang,

Chia,

Jaiswal

et al. 2024

International Journal of Surgery

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Background: Chronic steroid (CS) therapy was reportedly linked to increased vascular complications following percutaneous coronary intervention. However, its association with vascular complications after transcatheter aortic valve replacement (TAVR) remained uncertain, with conflicting results being reported. Objective: We aimed to compare the rate of vascular complications and outcomes between patients with and without (CS) use after TAVR. Methods: We conducted a comprehensive literature search in PubMed, Embase and Cochrane databases from their inception until 18th April 2022 for relevant studies. Endpoints were described according to Valve Academic Research Consortium-2 definitions. Effect sizes were pooled using DerSimonian and Laird random-effects model as risk ratio (RR) with 95% confidence intervals (CI). Results: 5 studies with 6136 patients undergoing TAVR were included in the analysis. The included studies were published between 2015 and 2022. The mean ages of patients in both study groups were similar, with the CS group averaging 80 years and the non-steroid group averaging 82 years. Notably, a higher proportion of patients in the CS group were female (56%) compared to the non-steroid group (54%). CS use was associated with a significantly higher risk of major vascular complications (12.5% vs. 6.7%, RR 2.32, 95% CI 1.73-3.11, P<0.001), major bleeding (16.8% vs. 13.1%, RR 1.61, 95% CI 1.27-2.05, P<0.001), and aortic annulus rupture (2.3% vs. 0.6%, RR 4.66, 95% CI 1.67-13.01, P<0.001). There was no significant difference in terms of minor vascular complications (RR 1.43, 95% CI 1.00-2.04, P=0.05), in-hospital mortality (2.3% vs. 1.4%, RR 1.86, 95% CI 0.74-4.70, P=0.19), and 30-day mortality (2.9% vs. 3.1%, RR 1.14, 95% CI 0.53-2.46, P=0.74) between both groups. Conclusion: Our study showed that CS therapy is associated with increased major vascular complications, major bleeding, and annulus rupture following TAVR. Further large multicenter studies or randomized controlled trials are warranted to validate these findings.

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Section: Methodsmentioning

confidence: 99%

Vascular complications and outcomes following transcatheter aortic valve replacement in patients on chronic steroid therapy: a meta-analysis

Ang,

Chia,

Jaiswal

et al. 2024

International Journal of Surgery

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“…This meta‐analysis was conducted and reported following the Cochrane and PRISMA (Preferred Reporting Items for Systematic review and Meta‐Analysis) 2020 guidelines and performed according to established methods, as described previously. 7 , 8 , 9 The prespecified study protocol has been registered in PROSPERO (CRD42023400480).…”

Section: Methodsmentioning

confidence: 99%

“…Over the past few decades, drug development endeavors for HCC have experienced major setbacks, characterized by four global Phase III trials (namely sunitinib, brivanib, linifanib, and erlotinib plus sorafenib) that yielded unsatisfactory results. 7 , 8 , 9 , 10 Specifically, these trials failed to demonstrate non‐inferiority or superiority compared to sorafenib regarding overall survival (OS) as a first‐line treatment for HCC. Sorafenib and lenvatinib are the widely adopted first‐line systemic treatments for advanced HCC.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of lenvatinib versus sorafenib in the primary treatment of advanced hepatocellular carcinoma: A meta‐analysis

Jaiswal,

Hameed,

Naz

et al. 2023

JGH Open

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Background and AimMolecular‐targeted agents such as lenvatinib and sorafenib have been approved to treat hepatocellular carcinoma (HCC). However, the choice between these two agents in the primary treatment for advanced HCC is still under debate with conflicting results. We sought to evaluate the efficacy of lenvatinib and sorafenib in patients with HCC.MethodsWe performed a systematic literature search using PubMed, Embase, and Scopus for relevant articles from inception until February 10, 2023. The primary outcome of this meta‐analysis was overall survival (OS). The secondary outcomes were progression‐free survival (PFS), time to progression, objective response rate (ORR), and disease control rate (DCR).ResultsA total of 13 studies with 3705 patients (1635 on lenvatinib and 2070 on sorafenib) were included in our analysis. The mean age of the patients in both groups was comparable (66.81 vs 65.9 years). Pooled analysis of primary outcomes showed that, compared with sorafenib, lenvatinib was associated with significantly better OS in patients treated with these drugs (HR 0.82, 95% CI: 0.69–0.97, P = 0.02). Pooled analysis also showed that PFS (HR 0.67, 95% CI: 0.57–0.78, P < 0.00001) and time to progression (HR 0.49, 95% CI: 0.31–0.79; P = 0.004) were significantly better in the lenvatinib group compared to the sorafenib group. It also showed that the lenvatinib group had significantly better ORR (odds ratio [OR] 5.43, 95% CI: 3.71–7.97; P < 0.00001) and DCR (OR 2.35, 95% CI: 1.75–3.16; P < 00001) than the sorafenib group.ConclusionOur study shows that lenvatinib is superior to sorafenib regarding OS and PFS in patients with advanced HCC.

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“…This meta-analysis was conducted and reported following the Cochrane and PRISMA (Preferred Reporting Items for Systematic Review and Meta-analysis) 2020 guidelines and performed according to established methods, as described previously. [15][16][17] The pre-specified study protocol has been registered in the PROSPERO (CRD42023424652).…”

Section: Me Thodsmentioning

confidence: 99%

Association between rheumatoid arthritis and atrial fibrillation: A systematic review and meta‐analysis

Jaiswal,

Roy,

Ang

et al. 2024

Journal of Arrhythmia

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Rheumatoid arthritis (RA) is an autoimmune disorder with a varying range of organs involved leading to adverse outcomes. However, very little is known, with conflicting results about the association between RA and atrial fibrillation (AF). We aim to evaluate the association between RA and AF, and other clinical outcomes. We performed a systematic literature search using PubMed, Embase, and Scopus for relevant articles from inception until September 10, 2023. Primary clinical outcomes were AF. Secondary outcomes were acute coronary syndrome (ACS), stroke, and all‐cause mortality (ACM). A total of 4 679 930 patients were included in the analysis, with 81 677 patients in the RA group and 4 493 993 patients in the nonrheumatoid arthritis (NRA) group. The mean age of the patients was 57.2 years. Pooled analysis of primary outcomes shows that RA groups of patients had a significantly higher risk of AF (odds ratios [OR], 1.53; 95% confidence interval [CI]: [1.16–2.03], p < .001) compared with NRA groups. Secondary Outcomes show that the RA group of patients had significantly higher odds of ACS (OR, 1.39; 95% CI: [1.26–1.52], p < .001), and ACM (OR, 1.19; 95% CI: [1.03–1.37], p = .02) compared with the NRA groups. However, the likelihood of stroke (OR, 1.02; 95% CI: [0.94–1.11], p = .61) was comparable between both groups of patients. Our study shows that RA groups of patients are at increased risk of having AF, ACS, and ACM.

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Racial Disparity Among the Clinical Outcomes Post-Myocardial Infarction Patients: A Systematic Review and Meta-analysis

Cited by 10 publications

References 20 publications

Vascular complications and outcomes following transcatheter aortic valve replacement in patients on chronic steroid therapy: a meta-analysis

Vascular complications and outcomes following transcatheter aortic valve replacement in patients on chronic steroid therapy: a meta-analysis

Efficacy of lenvatinib versus sorafenib in the primary treatment of advanced hepatocellular carcinoma: A meta‐analysis

Association between rheumatoid arthritis and atrial fibrillation: A systematic review and meta‐analysis

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