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Lobo LM, Masson W, Masson G, Molinero G, Lavalle Cobo A, Huerin M, Delgado J, Benincasa F, Losada P. Statins and influenza mortality: systematic review and meta-analysis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Due to their anti-inflammatory properties, it has been suggested that the use of statins could influence the evolution of influenza virus infection.
Objective
To evaluate the effect of statin therapy on mortality from influenza.
Material and methods
A meta-analysis that included studies evaluating the use of statins in patients with influenza and reporting data on mortality, after searching the PubMed/MEDLINE, Embase, and Cochrane Controlled Trials databases, was performed. A random effects model was applied. The risk of bias was analyzed and a sensitivity analysis was performed.
Results
Eight studies (10 independent cohorts), which included a total of 2,390,730 patients, were identified and eligible for analysis. A total of 1,146,995 subjects analyzed received statins, while 1,243,735 subjects were part of the control group. Statin therapy was associated with lower mortality (OR: 0.66; 95% CI: 0.51–0.85). The sensitivity analysis showed that the results were robust.
Conclusions
Our data suggest that, in a population with influenza, the use of statins was associated with a significant reduction in mortality. These results must be confirmed in future clinical trials.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- L M Lobo
- Campo de Mayo Military Hospital , Buenos Aires , Argentina
| | - W Masson
- Italian Hospital , Caba , Argentina
| | - G Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology , Caba , Argentina
| | - G Molinero
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology , Caba , Argentina
| | - A Lavalle Cobo
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology , Caba , Argentina
| | - M Huerin
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology , Caba , Argentina
| | - J Delgado
- Campo de Mayo Military Hospital , Buenos Aires , Argentina
| | - F Benincasa
- Campo de Mayo Military Hospital , Buenos Aires , Argentina
| | - P Losada
- Campo de Mayo Military Hospital , Buenos Aires , Argentina
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Lobo LM, Masson W, Molinero G, Levalle Cobo A, Benincasa F, Wehit G, Delgado J, Losada P, Suarez F, Barbagelata L. Role of statins in patients with MINOCA. A systematic review and meta-analysis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Given the complex etiology and a limited amount of evidence, the medical treatment (including statin use) of myocardial infarction with non-obstructive coronary artery disease (MINOCA) remains uncertain. The objective of the present study was to evaluate the effect of statin therapy on major cardiovascular events (MACE) and mortality in MINOCA patients.
Methods
A systematic review and meta-analysis of time-to-event outcomes were performed from statin's studies therapy on MINOCA patients, reporting data from MACE or mortality, after searching the PubMed/MEDLINE, Embase, Science Direct, Scopus, Google Scholar, and Cochrane databases.
The Meta-analysis Of Observational Studies (MOOSE) and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were used to check the reporting of observational studies. The quality of the included studies was assessed by two independent review authors using the Newcastle-Ottawa Scale (NOS). The summary effect of statin therapy on the endpoints were calculated. Measures of effect size were expressed as HRs, and the I2 statistic was calculated to quantify between-studies heterogeneity and inconsistency. A fixed-effects meta-analysis model and sensitivity analysis was then applied. The level of statistical significance was set at a 2-tailed alpha of 0.05.
Results
Six observational studies of statin therapy on MINOCA, involving a total of 11171 patients, were identified and considered eligible for analysis (9129 subjects received statin therapy while 2042 patients were part of the respective control arms). Quantitative analysis (5 studies were included) showed that statin use was associated with lower mortality (HR: 0.65; 95% CI: 0.56–0.75, I2: 0%). Also, the meta-analysis showed that statin therapy was associated with a lower incidence of MACE (HR: 0.78; 95% CI: 0.69–0.88, I2: 27%).
Conclusion
Our data suggest that in a population with MINOCA, the use of statin therapy results in significant reduction on MACE and mortality. These results must be confirmed in future clinical trials.
Funding Acknowledgement
Type of funding sources: None. Mortality and MACESensitivity analysis
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Affiliation(s)
- L M Lobo
- Campo de Mayo Military Hospital, Buenos Aires, Argentina
| | - W Masson
- Italian Hospital, Caba, Argentina
| | - G Molinero
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Caba, Argentina
| | - A Levalle Cobo
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Caba, Argentina
| | - F Benincasa
- Campo de Mayo Military Hospital, Buenos Aires, Argentina
| | - G Wehit
- Campo de Mayo Military Hospital, Buenos Aires, Argentina
| | - J Delgado
- Campo de Mayo Military Hospital, Buenos Aires, Argentina
| | - P Losada
- Campo de Mayo Military Hospital, Buenos Aires, Argentina
| | - F Suarez
- Campo de Mayo Military Hospital, Buenos Aires, Argentina
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Lobo LM, Masson G, Molinero G, Masson W, Giorgi MA, Siniawski D. P667Aspirin in primary prevention. Risks and benefits. Up date 2019. A meta-analysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
The usefulness of aspirin in patients without a cardiovascular history continues to be a subject of controversy.
Objectives
1. Perform an updated meta-analysis on the use of aspirin in primary cardiovascular prevention. 2. Analyze the results by risk.
Methods
This meta-analysis was performed according to the PRISMA guidelines. The primary endpoint was cardiovascular death, AMI, and ischemic stroke. The measures of effect size are expressed as odds ratios. The level of statistical significance was established at 0.05.
Characteristics of the studies Trials Year N Follow-up Risk RTPDABMD 1988 5,139 5.5 Middle PHS 1989 22,071 5 Low HOT 1998 18,790 3.8 Middle TPT 1998 5,085 6.7 Middle PPP 2001 44,95 3.6 Low WHS 2005 39,876 10.1 Low JPAD 2008 2,539 4.4 Low POPADAD 2008 1276 6.7 High AAA 2010 3,350 8.2 Low JPPP 2014 14,464 5 Low ASCEND 2018 15,480 7.4 Middle ARRIVE 2018 12,546 5 Low ASPREE 2018 19,114 4.7 Low RTPDABMD, Randomised trial of prophylactic daily aspirin in British male doctors; PHS, Physicians' Health Study; HOT, Hypertension Optimal Treatment; TPT, Thrombosis Prevention Trial; PPP, Primary Prevention Project; WHS, Women's Health Study; JPAD, Japanese Primary Prevention of Atherosclerosis With Aspirin for Diabetes; POPADAD, Prevention of Progression of Arterial Disease and Diabetes; AAA, Aspirin for Asymptomatic Atherosclerosis; JPPP, Japanese Primary Prevention Project; ASCEND, A Study of Cardiovascular Events in Diabetes; ARRIVE, Aspirin to Reduce Risk of Initial Vascular Events; ASPREE, Aspirin in Reducing Events in the Elderly.
Figure 1
Results
Thirteen works were considered for the analysis (Table 1). A total of 164,225 patients were included, 82,900 in the aspirin arm and 81,325 in the control group. A reduction of the primary endpoint was observed in the AAS group (OR 0.90, 95% CI 0.85–0.94). No differences by risk group (Figure 1). Risk of severe bleeding was significantly higher in patients treated with ASA (OR 1.45, 95% CI 1.34–1.56), this difference was maintained by risk (Figure 1).
Acknowledgement/Funding
None
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Affiliation(s)
- L M Lobo
- Campo de Mayo Military Hospital, Buenos Aires, Argentina
| | - G Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
| | - G Molinero
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
| | - W Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
| | - M A Giorgi
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
| | - D Siniawski
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
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Lobo LM, Masson W, Molinero G, Siniawski D, Huerin M, Nogueira JP, Valero R. 52Therapy with cholesteryl ester transfer protein (CETP) inhibitors and diabetes risk. A Meta-analysis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- L M Lobo
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
| | - W Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
| | - G Molinero
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
| | - D Siniawski
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
| | - M Huerin
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
| | | | - R Valero
- Aix-Marseille University, Department of Nutrition, Metabolic, Marseille, France
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Masson W, Epstein T, Huerín M, Lobo LM, Molinero G, Angel A, Masson G, Millán D, De Francesca S, Vitagliano L, Cafferata A, Losada P. Cardiovascular Risk Stratification in Patients with Metabolic Syndrome Without Diabetes or Cardiovascular Disease: Usefulness of Metabolic Syndrome Severity Score. High Blood Press Cardiovasc Prev 2017; 24:297-303. [PMID: 28502055 DOI: 10.1007/s40292-017-0209-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 05/05/2017] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION The estimated cardiovascular risk determined by the different risk scores, could be heterogeneous in patients with metabolic syndrome without diabetes or vascular disease. This risk stratification could be improved by detecting subclinical carotid atheromatosis. AIMS To estimate the cardiovascular risk measured by different scores in patients with metabolic syndrome and analyze its association with the presence of carotid plaque. METHODS Non-diabetic patients with metabolic syndrome (Adult Treatment Panel III definition) without cardiovascular disease were enrolled. The Framingham score, the Reynolds score, the new score proposed by the 2013 ACC/AHA Guidelines and the Metabolic Syndrome Severity Calculator were calculated. Prevalence of carotid plaque was determined by ultrasound examination. A Receiver Operating Characteristic analysis was performed. RESULTS A total of 238 patients were enrolled. Most patients were stratified as "low risk" by Framingham score (64%) and Reynolds score (70.1%). Using the 2013 ACC/AHA score, 45.3% of the population had a risk ≥7.5%. A significant correlation was found between classic scores but the agreement (concordance) was moderate. The correlation between classical scores and the Metabolic Syndrome Severity Calculator was poor. Overall, the prevalence of carotid plaque was 28.2%. The continuous metabolic syndrome score used in our study showed a good predictive power to detect carotid plaque (area under the curve 0.752). CONCLUSION In this population, the calculated cardiovascular risk was heterogenic. The prevalence of carotid plaque was high. The Metabolic Syndrome Severity Calculator showed a good predictive power to detect carotid plaque.
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Affiliation(s)
- Walter Masson
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina.
| | - Teo Epstein
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Melina Huerín
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Lorenzo Martín Lobo
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Graciela Molinero
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Adriana Angel
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Gerardo Masson
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Diana Millán
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Salvador De Francesca
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Laura Vitagliano
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Alberto Cafferata
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Pablo Losada
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
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