ObjectiveTo systematically review the association of body mass index (BMI) and mortality in chronic heart failure (CHF) pationts.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect cohort studies about the association of BMI and mortality in CHF patients from inception to June, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 12.0 software.ResultsA total of 20 cohort studies involving 91 572 CHF patients were included. The results of meta-analysis showed that, compared to patients with normal weight, underweight individuals were associated with higher mortality (HR=1.48, 95%CI 1.36 to 1.62, P<0.001), whereas overweight (HR=0.86, 95%CI 0.78 to 0.94, P=0.002) and obese (HR=0.78, 95%CI 0.68 to 0.90, P=0.001) patients were associated with lower mortality.ConclusionCurrent evidence shows that underweight is associated with a higher risk of all-cause mortality among patients with CHF, whereas overweight and obese are associated with lower risk of all-cause mortality. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
ObjectivesTo systematically review the efficacy and safety of esomeprazole versus omeprazole in the treatment of acute non-variceal upper gastrointestinal bleeding (ANVUGIB).MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect the randomized controlled trials (RCTs) about the efficacy and safety of esomeprazole versus omeprazole in the treatment of ANVUGIB from inception to January, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 17 RCTs involving 2 086 patients were included. The results of meta-analysis showed that, the total effective rate of esomeprazole group was higher than omeprazole group (RR=1.09, 95%CI 1.04 to 1.14, P=0.000 6), the incidence of adverse reactions was lower than omeprazole group (OR=0.27, 95%CI 0.18 to 0.40, P<0.000 01), the average hemostasis time was shorter than omeprazole group (MD=−0.64, 95%CI −0.94 to −0.34, P<0.0001), and the difference were statistically significant.ConclusionsCurrent evidence shows that in the treatment of ANVUGIB, esomeprazole has rapid hemostasis, significant effect and fewer adverse reactions, which is worthy of wide application and promotion. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
ObjectivesTo systematically review the efficacy and safety of ivabradine (IVA) for patients with chronic heart failure (CHF).MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy and safety of IVA for patients with CHF from inception to April, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed using Stata 12.0 software.ResultsA total of 22 RCTs involving 2 010 patients were included. The results of meta-analysis showed that, compared with control group, IVA group could decrease heart rate (HR) (WMD=−10.58, 95%CI −12.47 to −8.69, P=0.000) and N-terminal probrain natriuretic peptide (NT-proBNP) (WMD=−457.87, 95%CI −842.63 to −73.11, P=0.020). IVA group was superior in 6 minutes’ walk distance (6MWD) (WMD=40.49, 95%CI 27.83 to 53.15, P=0.000), left ventricular ejection fraction (LVEF) (WMD=5.11, 95%CI 3.74 to 6.48, P=0.000), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic dimension (LVEDd), left ventricular end-systolic dimension (LVESd) and incidence of endpoint events with significant difference. However, the total effective rate, the incidence of adverse reactions and blood pressures were similar between two groups.ConclusionCurrent evidence shows that IVA could significantly reduce HR, improve cardiac function and exercise tolerance in CHF patients with no significant increase of adverse events. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
ObjectivesTo systematically review the association between body mass index (BMI) and mortality of chronic obstructive pulmonary disease (COPD).MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect cohort studies on the association between BMI and mortality of COPD from inception to February, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 14 cohort studies involving 494 060 COPD patients were included. The results of meta-analysis showed that, compared with patients having a normal weight, underweight individuals were associated with higher mortality (RR=1.40, 95%CI 1.15 to 1.71, P=0.000 8), whereas overweight (RR=0.65, 95%CI 0.54 to 0.79, P<0.000 1) and obese (RR=0.37, 95%CI 0.20 to 0.67, P=0.001) patients were associated with lower mortality.ConclusionsCurrent evidence shows that underweight is associated with a higher risk of all-cause mortality among patients with COPD, whereas overweight and obese are associated with lower risk of all-cause mortality in these patients. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
ObjectiveTo systematically review the efficacy and safety of orlistat in the treatment of overweight and obese type 2 diabetes mellitus (T2DM). Methods PubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy and safety of orlistat in the treatment of overweight and obese T2DM patients from inception to June 29th, 2022. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies; then, meta-analysis was performed by using Stata 16.0 software. Results A total of 24 RCTs involving 3 702 patients were included. The results of meta-analysis showed that compared with control group, orlistat group could significantly decrease the levels of fasting blood glucose (WMD=1.04, 95%CI 0.80 to 1.29, P<0.001), 2h postprandial blood glucose (WMD=1.17, 95%CI 0.78 to 1.56, P<0.001) and hemoglobin A1c (WMD=0.84, 95%CI 0.51 to 1.17, P<0.001), and the levels of total cholesterol, triglyceride, low density lipoprotein, body weight and body mass index also significantly decreased (P<0.001). The incidence of adverse events such as increased defecation and abdominal pain of orlistat was slightly higher than that of control group; however, most could be self-healing.Conclusion Current evidence shows that orlistat can effectively and safely improve blood sugar, lipid index in overweight and obese T2DM patients. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically analyze the prevalence of cognitive impairment in patients with COPD.MethodsAn electronic search in PubMed, Embase, CNKI, WanFang Data and VIP databases to identify studies describing the prevalence of cognitive impairment in patients with COPD from inception to 3 May 2023. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, the meta-analysis was performed by using Stata16.0 software. ResultsA total of 40 studies involving 9, 988 patients with COPD were included. Meta-analysis showed that the total prevalence of cognitive impairment in patients with COPD was 48.26% (95%CI 42.39% to 54.20%). The results of subgroup analysis revealed that the prevalence of cognitive impairment in patients with acute exacerbation of COPD was higher than that in patients with stable-phase (58.62% vs. 49.71%). The prevalence of cognitive impairment in COPD patients was 29.07% before 2015, while the prevalence between 2015-2019 and 2020-2023 were higher, with rates of 53.06% and 48.26% respectively. The prevalence of cognitive impairment in domestic COPD patients was significantly higher than that in foreign patients (52.66% vs. 37.06%). ConclusionThe prevalence of cognitive impairment is relatively high in COPD patients, highlighting the need to strengthen the screening for cognitive impairment in COPD patients and provide early assessment and intervention.