1
|
Sedláková V, Mourcos S, Pupkaitė J, Lunn Y, Visintini S, Guzman-Soto I, Ruel M, Suuronen E, Alarcon EI. Biomaterials for direct cardiac repair-A rapid scoping review 2012-2022. Acta Biomater 2024:S1742-7061(24)00181-8. [PMID: 38588997 DOI: 10.1016/j.actbio.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/05/2023] [Revised: 03/13/2024] [Accepted: 04/03/2024] [Indexed: 04/10/2024]
Abstract
A plethora of biomaterials for heart repair are being tested worldwide for potential clinical application. These therapeutics aim to enhance the quality of life of patients with heart disease using various methods to improve cardiac function. Despite the myriad of therapeutics tested, only a minority of these studied biomaterials have entered clinical trials. This rapid scoping review aims to analyze literature available from 2012 to 2022 with a focus on clinical trials using biomaterials for direct cardiac repair, i.e., where the intended function of the biomaterial is to enhance the repair of the endocardium, myocardium, epicardium or pericardium. This review included neither biomaterials related to stents and valve repair nor biomaterials serving as vehicles for the delivery of drugs. Surprisingly, the literature search revealed that only 8 different biomaterials mentioned in 23 different studies out of 7038 documents (journal articles, conference abstracts or clinical trial entries) have been tested in clinical trials since 2012. All of these, intended to treat various forms of ischaemic heart disease (heart failure, myocardial infarction), were of natural origin and most used direct injections as their delivery method. This review thus reveals notable gaps between groups of biomaterials tested pre-clinically and clinically. STATEMENT OF SIGNIFICANCE: Rapid scoping review of clinical application of biomaterials for cardiac repair. 7038 documents screened; 23 studies mention 8 different biomaterials only. Biomaterials for repair of endocardium, myocardium, epicardium or pericardium. Only 8 different biomaterials entered clinical trials in the past 10 years. All of the clinically translated biomaterials were of natural origin.
Collapse
Affiliation(s)
- Veronika Sedláková
- Department of Histology and Embryology, Faculty of Medicine, Masaryk University, Kamenice 753/5, Brno 625 00, Czechia.
| | - Sophia Mourcos
- BEaTS Research, Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada; Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada; Department of Biomedical Science, Faculty of Science, University of Ottawa, 150 Louis-Pasteur Private, Ottawa, Ontario K1N 9A7, Canada
| | - Justina Pupkaitė
- BEaTS Research, Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
| | - Yvonne Lunn
- BEaTS Research, Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada; Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada; Department of Biochemistry, Microbiology, and Immunology, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada
| | - Sarah Visintini
- Berkman Library, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
| | - Irene Guzman-Soto
- BEaTS Research, Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
| | - Marc Ruel
- BEaTS Research, Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada; Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
| | - Erik Suuronen
- BEaTS Research, Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada; Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada; Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada
| | - Emilio I Alarcon
- BEaTS Research, Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada; Division of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada; Department of Biochemistry, Microbiology, and Immunology, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada.
| |
Collapse
|
2
|
Quansah DY, Lewis R, Savard K, Harris L, Visintini S, Coutinho T, Mullen KA. Cardiovascular Disease Risk Factor Interventions in Women With Prior Gestational Hypertensive Disorders or Diabetes in North America: A Rapid Review. CJC Open 2024; 6:153-164. [PMID: 38487059 PMCID: PMC10935679 DOI: 10.1016/j.cjco.2023.12.015] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/13/2023] [Indexed: 03/17/2024] Open
Abstract
Women with previous hypertensive disorders of pregnancy (HDP) or gestational diabetes mellitus (GDM) have a 2- to 3-fold increased risk of cardiovascular disease (CVD). The goal of this rapid review was to summarize evidence of the effectiveness of CVD risk factor interventions for postpartum women with a history of HDP or GDM. A comprehensive search strategy was used to search articles published in 5 databases-Ovid MEDLINE, PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, and Embase). Observational and intervention studies that identified CVD prevention, screening, and/or risk factor management interventions among postpartum women with prior HDP or GDM in Canada and the US were included. The quality of observational and interventional studies, and their risk of bias, were assessed using appropriate critical appraisal checklists. Eight studies, including 4 observational cohorts, 3 randomized controlled trials, and 1 quasi-experimental study, merited inclusion for analysis. A total of 2449 participants were involved in the included studies. The most effective CVD risk factor intervention was comprised of postpartum transition and follow-up, CVD risk factor education, and advice on lifestyle changes. Most of the observational studies led to improvements in CVD risk factors, including improvements in CVD lifetime risk scores. However, none of the RCTs led to improvements in cardiometabolic risk factors. Few studies have investigated CVD risk factor interventions in the postpartum in women with previous HDP or GDM in North America. Further studies of higher quality are needed.
Collapse
Affiliation(s)
- Dan Yedu Quansah
- Canadian Women’s Heart Health Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Rebekah Lewis
- Canadian Women’s Heart Health Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Karine Savard
- Canadian Women’s Heart Health Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Laura Harris
- Canadian Women’s Heart Health Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Sarah Visintini
- Berkman Library, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Thais Coutinho
- Canadian Women’s Heart Health Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Kerri-Anne Mullen
- Canadian Women’s Heart Health Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| |
Collapse
|
3
|
Kadoya Y, Balamane S, Visintini S, Chow B. The efficacy of inspiratory muscle training in patients with coronary artery disease: Protocol for a systematic review and meta-analysis. PLoS One 2023; 18:e0289287. [PMID: 37682851 PMCID: PMC10490982 DOI: 10.1371/journal.pone.0289287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 06/21/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Inspiratory muscle training (IMT) has been recognized as an effective form of training in patients with cardiovascular disease and heart failure. However, little is known about the efficacy of IMT in the treatment of patients with coronary artery disease (CAD). The aim of this systematic review will be to evaluate randomized controlled studies to understand the effect of IMT on CAD patients. METHOD We will include randomized controlled trials evaluating the efficacy of IMT in patients 18 years and older diagnosed with CAD. Crossover trials, cluster-randomized, quasi-randomized, and non-randomized trials will be excluded. Study search will be conducted in major databases (MEDLINE, the Cochrane Central Register of Controlled Trials, Embase, and PEDro). The study intervention will be IMT independent of the duration, frequency, or intensity of training. The primary outcome will be quality of life, patient-reported health status, and all adverse events related to IMT. Secondary outcomes will include exercise capacity and respiratory muscle strength. The risk of bias will be evaluated based on the Cochrane Risk of Bias tool. Screening, data extraction, and quality assessment will be performed by two independent reviewers. If two or more studies are considered to be clinically homogeneous, a meta-analysis based on the random-effects model will be performed. The quality of evidence will be evaluated based on the GRADE approach. CONCLUSION This systematic review will improve our understanding of the effects of IMT on CAD patients and potentially establish IMT as an alternative form of exercise training for the treatment of CAD. TRIAL REGISTRATION Study registration. OSF registries (https://osf.io/3ch7m). Date registered: May 10, 2022. Registration DOI: https://doi.org/10.17605/OSF.IO/GVMY7.
Collapse
Affiliation(s)
- Yoshito Kadoya
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Saad Balamane
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Faculty of Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Sarah Visintini
- Berkman Library, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Benjamin Chow
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| |
Collapse
|
4
|
Abdel-Razek O, Di Santo P, Jung RG, Parlow S, Motazedian P, Prosperi-Porta G, Visintini S, Marbach JA, Ramirez FD, Simard T, Labinaz M, Mathew R, Hibbert B. Efficacy of Milrinone and Dobutamine in Cardiogenic Shock: An Updated Systematic Review and Meta-Analysis. Crit Care Explor 2023; 5:e0962. [PMID: 37649849 PMCID: PMC10465094 DOI: 10.1097/cce.0000000000000962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVES Inotropic support is commonly used in patients with cardiogenic shock (CS). High-quality data guiding the use of dobutamine or milrinone among this patient population is limited. We compared the efficacy and safety of these two inotropes among patients with low cardiac output states (LCOS) or CS. DATA SOURCES MEDLINE, Embase, and Cochrane Central Register of Controlled Trials were searched up to February 1, 2023, using key terms and index headings related to LCOS or CS and inotropes. DATA EXTRACTION Two independent reviewers included studies that compared dobutamine to milrinone on all-cause in-hospital mortality, length of ICU stay, length of hospital stay, and significant arrhythmias in hospitalized patients. DATA SYNTHESIS A total of eleven studies with 21,084 patients were included in the meta-analysis. Only two randomized controlled trials were identified. The primary outcome, all-cause mortality, favored milrinone in observational studies only (odds ratio [OR] 1.19 (95% CI, 1.02-1.39; p = 0.02). In-hospital length of stay (LOS) was reduced with dobutamine in observational studies only (mean difference -1.85 d; 95% CI -3.62 to -0.09; p = 0.04). There was no difference in the prevalence of significant arrhythmias or in ICU LOS. CONCLUSIONS Only limited data exists supporting the use of one inotropic agent over another exists. Dobutamine may be associated with a shorter hospital LOS; however, there is also a potential for increased all-cause mortality. Larger randomized studies sufficiently powered to detect a difference in these outcomes are required to confirm these findings.
Collapse
Affiliation(s)
- Omar Abdel-Razek
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Pietro Di Santo
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Richard G Jung
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Division of Internal Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Simon Parlow
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Pouya Motazedian
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Graeme Prosperi-Porta
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Sarah Visintini
- Berkman Library, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Jeffrey A Marbach
- Division of Cardiovascular Medicine, Knight Cardiovascular Center, Oregon Health and Science University, Portland, OR
| | - F Daniel Ramirez
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Trevor Simard
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Marino Labinaz
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Rebecca Mathew
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Benjamin Hibbert
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| |
Collapse
|
5
|
Backman C, Papp S, Harley A, Tonjock Kolle A, Visintini S, Shah S, Berdusco R, Poitras S, Beaulé PE, French-Merkley V. Platform-Based Patient-Clinician Digital Health Interventions for Care Transitions: Protocol for a Scoping Review. JMIR Res Protoc 2023; 12:e42056. [PMID: 37018041 PMCID: PMC10131754 DOI: 10.2196/42056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/18/2023] [Accepted: 01/24/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND With the increased adoption of technology, the use of digital health interventions in health care settings has increased. Patient-clinician digital health interventions have the potential to improve patient care, especially during important transitions between hospital and home. Digital health interventions can provide support to patients during these transitions, thereby leading to better patient outcomes. OBJECTIVE This scoping review aims to explore the available literature, specifically (1) to examine the impact of platform-based digital health interventions focused on care transitions on patient outcomes, and (2) to identify the barriers to and enablers for the uptake and implementation of these digital health interventions. METHODS This protocol was developed based on Arksey and O'Malley's, Levac and colleagues', and JBI scoping review methodologies, and it has been reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement for the Scoping Reviews) format. The search strategies were developed for 4 databases: MEDLINE, CINAHL, EMBASE, and the Cochrane Central Register of Controlled Trials by using key words such as "hospital to home transition" and "platform-based digital health." Studies involving patients 16 years or older that used a platform-based digital health intervention during their hospital to home transition will be included in this review. Two reviewers will independently screen articles for eligibility by using a 2-stage process (ie, title and abstract screening and full-text screening). We expect to refine the eligibility criteria during the title and abstract screening process as we anticipate retrieving a significant number of articles. In addition, we will also perform a targeted search of the grey literature, as well as data extraction. Data analysis will consist of a narrative and descriptive synthesis. RESULTS The review is expected to identify research gaps that will inform the development of future patient-clinician digital health interventions. We have identified a total of 8333 articles. Screening began in September 2022, and data extraction is expected to commence in February 2023 and end by April 2023. Data analyses and final results will be submitted to a peer-reviewed journal in August 2023. CONCLUSIONS We expect to find a wide variety of postcare interventions, some gaps in the quality of research evidence, as well as a lack of detailed information on digital health interventions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/42056.
Collapse
Affiliation(s)
| | | | | | | | | | - Soha Shah
- Bruyère Continuing Care, Ottawa, ON, Canada
| | | | | | | | | |
Collapse
|
6
|
Seguin N, Visintini S, Muldoon KA, Walker M. Use of tranexamic acid (TXA) to reduce preterm birth and other adverse obstetrical outcomes among pregnant individuals with placenta previa: a systematic review protocol. BMJ Open 2023; 13:e068892. [PMID: 36882250 PMCID: PMC10008160 DOI: 10.1136/bmjopen-2022-068892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
INTRODUCTION Placenta previa is a placental implantation pathology where the placenta overlies the internal endocervical os. Placenta previa affects approximately 4 per 1000 pregnancies and increases the risk of antepartum bleeding, emergent preterm labour and emergency caesarean sections. Currently, placenta previa is managed through expectant management. Guidelines primarily revolve around the mode and timing of delivery, in-hospital admissions and surveillance. However, the methods to prolong pregnancy have not proven to be clinically effective. Tranexamic acid (TXA), an antifibrinolytic agent, is effectively used to prevent and treat postpartum haemorrhage as well as menorrhagia, with limited adverse effect, and may prove to be an effective treatment for placenta previa. The objective of this systematic review protocol is to review and synthesise the evidence of TXA use for antepartum haemorrhage in placenta previa. METHODS AND ANALYSIS Preliminary searches were conducted on 12 July 2022. We will search MEDLINE, EMBASE, CINAHL, Scopus and the Cochrane Central Register of Controlled Trials. Grey literature resources such as clinical trials registries (ClinicalTrials.gov and the WHO's International Clinical Trials Registry) and preprint servers (Europe PMC and Open Science Framework) will also be searched. The search terms will comprise of index headings and keyword searches related to TXA and the placenta or antepartum bleeding. Cohort and randomised and non-randomised trials will be considered. The target population is pregnant people, of any age, with placenta previa. The intervention is TXA given in the antepartum period. The main outcome of interest is preterm birth before 37 weeks, however, all perinatal outcomes will be collected. Title and abstract will be screened by two reviewers and any conflict will be discussed and evaluated by a third reviewer. The literature will be summarised in narrative form. ETHICS AND DISSEMINATION No ethics approval is required for this protocol. Findings will be disseminated through peer-review publication, lay summaries and conference presentations. PROSPERO REGISTRATION NUMBER CRD42022363009).
Collapse
Affiliation(s)
- Niève Seguin
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Sarah Visintini
- Berkman Library, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Katherine A Muldoon
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada
| | - Mark Walker
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada
- International and Global Health Office, University of Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|
7
|
Willner N, Prosperi-Porta G, Lau L, Nam Fu AY, Boczar K, Poulin A, Di Santo P, Unni RR, Visintini S, Ronksley PE, Chan KL, Beauchesne L, Burwash IG, Messika-Zeitoun D. Aortic Stenosis Progression: A Systematic Review and Meta-Analysis. JACC Cardiovasc Imaging 2023; 16:314-328. [PMID: 36648053 DOI: 10.1016/j.jcmg.2022.10.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Aortic valve stenosis is a progressive disorder with variable progression rates. The factors affecting aortic stenosis (AS) progression remain largely unknown. OBJECTIVES This systematic review and meta-analysis sought to determine AS progression rates and to assess the impact of baseline AS severity and sex on disease progression. METHODS The authors searched Medline, Embase, and the Cochrane Central Register of Controlled Trials from inception to July 1, 2020, for prospective studies evaluating the progression of AS with the use of echocardiography (mean gradient [MG], peak velocity [PV], peak gradient [PG], or aortic valve area [AVA]) or computed tomography (calcium score [AVC]). Random-effects meta-analysis was performed to evaluate the rate of AS progression for each parameter stratified by baseline severity, and meta-regression was performed to determine the impact of baseline severity and of sex on AS progression rate. RESULTS A total of 24 studies including 5,450 patients (40% female) met inclusion criteria. The pooled annualized progression of MG was +4.10 mm Hg (95% CI: 2.80-5.41 mm Hg), AVA -0.08 cm2 (95% CI: 0.06-0.10 cm2), PV +0.19 m/s (95% CI: 0.13-0.24 m/s), PG +7.86 mm Hg (95% CI: 4.98-10.75 mm Hg), and AVC +158.5 AU (95% CI: 55.0-261.9 AU). Increasing baseline severity of AS was predictive of higher rates of progression for MG (P < 0.001), PV (P = 0.001), and AVC (P < 0.001), but not AVA (P = 0.34) or PG (P = 0.21). Only 4 studies reported AS progression stratified by sex, with only PV and AVC having 3 studies to perform a meta-analysis. No difference between sex was observed for PV (P = 0.397) or AVC (P = 0.572), but the level of confidence was low. CONCLUSIONS This study provides progression rates for both hemodynamic and anatomic parameters of AS and shows that increasing hemodynamic and anatomic baseline severity is associated with faster AS progression. More studies are needed to determine if sex differences affect AS progression. (Aortic Valve Stenosis Progression Rate: A Systematic Review and Meta-Analysis; CRD42021207726).
Collapse
Affiliation(s)
- Nadav Willner
- Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | | | - Lawrence Lau
- Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Angel Yi Nam Fu
- Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Kevin Boczar
- Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Anthony Poulin
- Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Pietro Di Santo
- Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Rudy R Unni
- Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Sarah Visintini
- Berkman Library, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Paul E Ronksley
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Kwan-Leung Chan
- Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Luc Beauchesne
- Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Ian G Burwash
- Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | | |
Collapse
|
8
|
Chan E, Rooprai J, Rodger J, Visintini S, Rodger N, Philip S, Mielniczuk L, Sun LY. Sex-based differences in referral of heart failure patients to outpatient clinics: a scoping review. ESC Heart Fail 2022; 9:3702-3712. [PMID: 36069110 PMCID: PMC9773741 DOI: 10.1002/ehf2.14143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 07/26/2022] [Accepted: 08/24/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Guidelines recommend that hospitalized patients newly diagnosed with HF be referred to an outpatient HF clinic (HFC) within 2 weeks of discharge. Our study aims were (i) to assess the current literary landscape on the impact of patient sex on HFC referral and outcomes and (ii) to provide a qualitative overview of possible considerations for the impact of sex on referral patterns and HF characteristics including aetiology, symptom severity, investigations undertaken and pharmacologic therapy. METHODS AND RESULTS We conducted a scoping review using the Arksey and O'Malley framework and searched Medline, EMBASE, PsychINFO, Cochrane Library, Ageline databases and grey literature. Eligible articles included index HF hospitalizations or presentations to the Emergency Department (ED), a description of the HFC referral of patients not previously followed by an HF specialist and sex-specific analysis. Of the 11 372 potential studies, 8 met the inclusion criteria. These studies reported on a total of 11 484 participants, with sample sizes ranging between 168 and 3909 (25.6%-50.7% female). The included studies were divided into two groups: (i) those outlining the referral process to an HFC and (ii) studies which include patients newly enrolled in an HFC. Of the studies in Group 1, males (51%-82.4%) were more frequently referred to an HFC compared with females (29%-78.1%). Studies in Group 2 enrolled a higher proportion of males (62%-74% vs. 26%-38%). One study identified independent predictors of HFC referral which included male sex, younger age, and the presence of systolic dysfunction, the latter two more often found in males. Two studies, one from each group reported a higher mortality amongst males compared with females, whereas another study from Group 2 reported a higher hospitalization rate amongst females following HFC assessment. CONCLUSIONS Males were more likely than females to be referred to HFCs after hospitalization and visits to the Emergency Department, however heterogeneity across studies precluded a robust assessment of sex-based differences in outcomes. This highlights the need for more comprehensive longitudinal data on HF patients discharged from the acute care setting to better understand the role of sex on patient outcomes.
Collapse
Affiliation(s)
- Elizabeth Chan
- Division of CardiologyUniversity of Ottawa Heart InstituteOttawaOntarioCanada
| | - Jasjit Rooprai
- Department of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Jillian Rodger
- Department of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Sarah Visintini
- Berkman LibraryUniversity of Ottawa Heart InstituteOttawaOntarioCanada
| | - Norvinda Rodger
- Clinical ServicesUniversity of Ottawa Heart InstituteOttawaOntarioCanada
| | - Shona Philip
- Department of Blood and Marrow TransplantStanford University Medical CenterPalo AltoCaliforniaUSA
| | - Lisa Mielniczuk
- Division of CardiologyUniversity of Ottawa Heart InstituteOttawaOntarioCanada
| | - Louise Y. Sun
- Division of Cardiac AnesthesiologyUniversity of Ottawa Heart InstituteOttawaOntarioCanada
| |
Collapse
|
9
|
Elliott CG, Vidal-Almela S, Harvey P, O’Donnell E, Scheid JL, Visintini S, Reed JL. Examining the Role of Physical Activity Interventions in Modulating Androgens and Cardiovascular Health in Postmenopausal Women: A Narrative Review. CJC Open 2022; 5:54-71. [PMID: 36700183 PMCID: PMC9869362 DOI: 10.1016/j.cjco.2022.10.008] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/11/2022] [Indexed: 11/10/2022] Open
Abstract
A growing body of literature has examined the role of physical activity (PA) in modifying the effects of estrogen withdrawal on cardiovascular health in postmenopausal women, but the impact of PA on androgens is less clear. Changes in androgen concentrations following regular PA may improve cardiovascular health. This narrative review summarizes the literature assessing the impact of PA interventions on androgens in postmenopausal women. The association between changes in androgen concentrations and cardiovascular health following PA programs is also examined. Randomized controlled trials were included if they (i) implemented a PA program of any type and duration in postmenopausal women and (ii) measured changes in androgen concentrations. Following PA interventions, no changes in androstenedione, conflicting changes in dehydroepiandrosterone/dehydroepiandrosterone-sulfate, and increases in sex hormone-binding globulin concentrations were found. Total testosterone decreased following aerobic PA but increased after resistance training. Most aerobic PA interventions led to reductions in free testosterone. A combination of caloric restriction and/or fat loss enhanced the influence of PA on most androgens. Evidence exploring the relationship between changes in androgens and cardiovascular health indicators was scarce and inconsistent. PA has shown promise in modifying the concentrations of some androgens (free and total testosterone, sex hormone-binding globulin), and remains a well-known beneficial adjuvant option for postmenopausal women to manage their cardiovascular health. Fat loss influences the effect of PA on androgens, but the synergistic role of PA and androgens on cardiovascular health merits further examination. Many research gaps remain regarding the relationship between PA, androgens, and cardiovascular disease in postmenopausal women.
Collapse
Affiliation(s)
- Cara G. Elliott
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada,Department of Obstetrics and Gynaecology, Western University, London, Ontario, Canada,Corresponding author: Dr Cara G. Elliott, Department of Obstetrics and Gynaecology, Western University, 1151 Richmond St, London, Ontario N6A 3K7, Canada. Tel.: +1-661-3459
| | - Sol Vidal-Almela
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada,School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Paula Harvey
- Women’s College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Emma O’Donnell
- School of Sport and Exercise Health Sciences, National Centre of Sports and Exercise Medicine, Loughborough University, Loughborough, England, United Kingdom
| | - Jennifer L. Scheid
- Department of Health Promotion and Physical Therapy, Daemen College, Amherst, New York, USA
| | - Sarah Visintini
- Berkman Library, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Jennifer L. Reed
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada,School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|
10
|
Parry M, Visintini S, Johnston A, Colella TJ, Kapur D, Liblik K, Gomes Z, Dancey S, Liu S, Goodenough C, Hay JL, Noble M, Adreak N, Robert H, Tang N, O'Hara A, Wong A, Mullen KA. Peer-support interventions for women with cardiovascular disease: protocol for synthesising the literature using an evidence map. BMJ Open 2022; 12:e067812. [PMID: 36198466 PMCID: PMC9535150 DOI: 10.1136/bmjopen-2022-067812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION The leading cause of death for women is cardiovascular disease (CVD), including ischaemic heart disease, stroke and heart failure. Previous literature suggests peer support interventions improve self-reported recovery, hope and empowerment in other patient populations, but the evidence for peer support interventions in women with CVD is unknown. The aim of this study is to describe peer support interventions for women with CVD using an evidence map. Specific objectives are to: (1) provide an overview of peer support interventions used in women with ischaemic heart disease, stroke and heart failure, (2) identify gaps in primary studies where new or better studies are needed and (3) describe knowledge gaps where complete systematic reviews are required. METHODS AND ANALYSIS We are building on previous experience and expertise in knowledge synthesis using methods described by the Evidence for Policy and Practice Information (EPPI) and the Coordinating Centre at the Institute of Education. Seven databases will be searched from inception: CINAHL, Embase, MEDLINE, APA PsycINFO, the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials, and Scopus. We will also conduct grey literature searches for registered clinical trials, dissertations and theses, and conference abstracts. Inclusion and exclusion criteria will be kept broad, and studies will be included if they discuss a peer support intervention and include women, independent of the research design. No date or language limits will be applied to the searches. Qualitative findings will be summarised narratively, and quantitative analyses will be performed using R. ETHICS AND DISSEMINATION The University of Toronto's Research Ethics Board granted approval on 28 April 2022 (Protocol #42608). Bubble plots (ie, weighted scatter plots), geographical heat/choropleth maps and infographics will be used to illustrate peer support intervention elements by category of CVD. Knowledge dissemination will include publication, presentation/public forums and social media.
Collapse
Affiliation(s)
- Monica Parry
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Visintini
- Berkman Library, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Health Sciences Library, University of Ottawa, Ottawa, Ontario, Canada
| | - Amy Johnston
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Tracey Jf Colella
- Toronto Rehabilitation Cardiovascular Prevention & Rehabilitation Program, KITE - University Health Network, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing and the Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Deeksha Kapur
- Lawrence S. Bloomberg Faculty of Nursing (Research Assistant), University of Toronto, Toronto, Ontario, Canada
| | - Kiera Liblik
- School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Zoya Gomes
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sonia Dancey
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Shuangbo Liu
- Section of Cardiology, Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Catherine Goodenough
- Canadian Women's Heart Health Alliance, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Jacqueline L Hay
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada
- Institute of Cardiovascular Sciences, St Boniface General Hospital Albrechtsen Research Centre, Winnipeg, Manitoba, Canada
| | - Meagan Noble
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Indigenous Services Canada, Toronto, Ontario, Canada
| | - Najah Adreak
- Department of Surgery, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Helen Robert
- Canadian Women's Heart Health Alliance, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Natasha Tang
- School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Arland O'Hara
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Anice Wong
- Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Kerri-Anne Mullen
- Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| |
Collapse
|
11
|
Clifford CR, Boudreau R, Visintini S, Orr N, Fu AYN, Malhotra N, Barry Q, So DYF. The association of PRECISE-DAPT score with ischaemic outcomes in patients taking dual antiplatelet therapy following percutaneous coronary intervention: a meta-analysis. Eur Heart J Cardiovasc Pharmacother 2022; 8:511-518. [PMID: 34849686 DOI: 10.1093/ehjcvp/pvab080] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/09/2021] [Accepted: 11/18/2021] [Indexed: 06/13/2023]
Abstract
AIMS The PRECISE-DAPT (Predicting Bleeding Complication in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy) score identifies patients at high risk of bleeding complications following percutaneous coronary intervention (PCI). International guidelines recommend the PRECISE-DAPT score to identify patients at high risk for bleeding, who may benefit from shortened dual antiplatelet therapy. The association of the PRECISE-DAPT score with ischaemic outcomes remains unclear. We performed a meta-analysis investigating the association between a high PRECISE-DAPT score and ischaemic outcomes. METHODS AND RESULTS A comprehensive literature search was conducted on articles published between 11 March 2017 and 5 June 2021. Two reviewers independently screened articles for inclusion using pre-defined criteria. The outcome measures extracted included composite ischaemic events, major bleeding events, and all-cause mortality. A random effects model was applied to obtain combined risk estimates for outcomes. From 12 included studies, there were 39 459 patients with PRECISE-DAPT <25 and 14 761 patients with PRECISE-DAPT ≥25. PRECISE-DAPT score ≥25 was associated with increased risk of composite ischaemic events [odds ratio (OR) 2.16; 95% confidence interval (CI) 1.77-2.65], myocardial infarction (OR 2.06; 95% CI 1.38-3.08), and ischaemic stroke (OR 2.90; 95% CI 1.76-4.78). Patients with a PRECISE-DAPT score ≥25 had increased risk of major bleeding (OR 3.62; 95% CI 2.62-4.99). Patients with a PRECISE-DAPT score ≥25 had higher risk of all-cause mortality (OR 5.83; 95% CI 5.37-6.33). CONCLUSION Patients with a PRECISE-DAPT score ≥25 are at increased risk for ischaemic events, bleeding, and all-cause mortality. Prospective evaluation of a PRECISE-DAPT guided approach to antiplatelet therapy is required to demonstrate benefit in this high-risk population.
Collapse
Affiliation(s)
- Cole R Clifford
- Division of Cardiology, University of Ottawa Heart Institute, Room H3408, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
| | - Rene Boudreau
- Division of Cardiology, University of Ottawa Heart Institute, Room H3408, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
| | - Sarah Visintini
- Berkamn Library, University of Ottawa Heart Institute, Ottawa, Ontario K1Y 4W7, Canada
| | - Nathan Orr
- Berkamn Library, University of Ottawa Heart Institute, Ottawa, Ontario K1Y 4W7, Canada
| | - Angel Y N Fu
- Division of Cardiology, University of Ottawa Heart Institute, Room H3408, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
| | - Nikita Malhotra
- Division of Cardiology, University of Ottawa Heart Institute, Room H3408, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
| | - Quinton Barry
- Division of Cardiology, University of Ottawa Heart Institute, Room H3408, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
| | - Derek Y F So
- Division of Cardiology, University of Ottawa Heart Institute, Room H3408, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
| |
Collapse
|
12
|
Abdel-Razek O, Jung Y, Jung R, Skanes S, Dhaliwal S, Stotts C, Di Santo P, Goh CY, Verreault-Julien L, Visintini S, Bradley J, Simard T, Ramirez FD, Russo JJ, Froeschl M, Labinaz M, Hibbert B. Safety of same-day discharge in patients with left main percutaneous intervention. Coron Artery Dis 2022; 33:415-418. [PMID: 35170549 PMCID: PMC9239435 DOI: 10.1097/mca.0000000000001121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 12/12/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Omar Abdel-Razek
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa
| | - Young Jung
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton
| | - Richard Jung
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa
- Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | | | - Shan Dhaliwal
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Cameron Stotts
- Department of Biochemistry, Microbiology, and Immunology, Faculty of Medicine, University of Ottawa, Ottawa
| | - Pietro Di Santo
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa
- Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa
- School of Epidemiology and Public Health, University of Ottawa, Ottawa
| | - Cheng Yee Goh
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa
| | | | - Sarah Visintini
- Berkman Library, University of Ottawa Heart Institute, Ottawa, Canada
| | - Jennifer Bradley
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa
| | - Trevor Simard
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - F. Daniel Ramirez
- Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Juan J. Russo
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa
| | - Michael Froeschl
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa
| | - Marino Labinaz
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa
| | - Benjamin Hibbert
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa
- Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| |
Collapse
|
13
|
Boczar KE, Shin S, Bezzina KA, Geejo A, Pearson AL, Shahab S, Fehlmann CA, Visintini S, Beanlands R, Wells GA. Examining anti-inflammatory therapies in the prevention of cardiovascular events: protocol for a systematic review and network meta-analysis of randomised controlled trials. BMJ Open 2022; 12:e062702. [PMID: 35760536 PMCID: PMC9237867 DOI: 10.1136/bmjopen-2022-062702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Inflammation is emerging as an important risk factor for atherosclerotic cardiovascular disease and has been a recent target for many novel therapeutic agents. However, comparative evidence regarding efficacy of these anti-inflammatory treatment options is currently lacking. METHODS AND ANALYSIS This systematic review will include randomised controlled trials evaluating the effect of anti-inflammatory agents on cardiovascular outcomes in patients with known cardiovascular disease. Studies will be retrieved from Medline, Embase, the Cochrane Central Register of Controlled Trials, as well as clinical trial registry websites, Europe PMC and conference abstract handsearching. No publication date or language restrictions will be imposed. Eligible interventions must have some component of anti-inflammatory agent. These include (but are not limited to): non-steroidal anti-inflammatory drugs (NSAIDs), colchicine, prednisone, methotrexate, canakinumab, pexelizumab, anakinra, succinobucol, losmapimod, inclacumab, atreleuton, LP-PLA2 (darapladib) and sPLA2 (varespladib). The primary outcomes will include major adverse cardiac events (MACE), and each individual component of MACE (myocardial infarction, stroke and cardiovascular death). Key secondary outcomes will include unstable angina, heart failure, all-cause mortality, cardiac arrest and revascularisation. Screening, inclusion, data extraction and quality assessment will be performed independently by two reviewers. Network meta-analysis based on the random effects model will be conducted to compare treatment effects both directly and indirectly. The quality of the evidence will be assessed with appropriate tools including the Grading of Recommendations, Assessment, Development and Evaluation profiler or Confidence in Network Meta-Analysis tool. ETHICS AND DISSEMINATION Ethics approval is not required for this systematic review. The findings will be disseminated through a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42022303289.
Collapse
Affiliation(s)
- Kevin Emery Boczar
- Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Sheojung Shin
- Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | | | - Aishwarya Geejo
- Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | | | - Saba Shahab
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Christophe A Fehlmann
- University of Ottawa, Ottawa, Ontario, Canada
- Geneva University Hospitals, Geneva, Switzerland
| | - Sarah Visintini
- Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Rob Beanlands
- Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - George A Wells
- Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|
14
|
Parlow S, Fay Lepage-Ratte M, Jung RG, Fernando SM, Visintini S, Sterling LH, Di Santo P, Simard T, Russo JJ, Labinaz M, Hibbert B, Nolan JP, Rochwerg B, Mathew R. Inhaled anaesthesia compared with conventional sedation in post cardiac arrest patients undergoing temperature control: a systematic review and meta-analysis. Resuscitation 2022; 176:74-79. [DOI: 10.1016/j.resuscitation.2022.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/19/2022] [Accepted: 05/21/2022] [Indexed: 10/18/2022]
|
15
|
Unni RR, Prager RT, Odabashian R, Zhang JJ, Fat Hing NN, Nery PB, Pi L, Aldawood W, Sadek MS, Redpath CJ, Birnie DH, Alqarawi W, Zagzoog A, Golian M, Klein A, Ramirez FD, Green MS, Chen L, Visintini S, Wells GA, Nair GM. Rhythm Monitoring Strategy and Arrhythmia Recurrence in Atrial Fibrillation Ablation Trials: A Systematic Review. CJC Open 2022; 4:488-496. [PMID: 35607484 PMCID: PMC9123375 DOI: 10.1016/j.cjco.2022.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/07/2022] [Indexed: 11/24/2022] Open
Abstract
Background : The rhythm-monitoring strategy after catheter ablation (CA) for atrial fibrillation (AF) impacts the detection of atrial arrhythmia recurrence and is not well characterized. We performed a systematic review and meta-regression analysis to determine whether the duration and mode of rhythm monitoring after CA affects detection of atrial arrhythmia recurrence. Methods Databases were systematically searched for randomized controlled trials of adult patients undergoing first CA for AF from 2007 to 2021. Duration and strategy of rhythm monitoring were extracted. Meta-regression was used to identify any association between duration of monitoring and detection of atrial arrhythmia recurrence. The primary measure of outcome was single-procedure recurrence of atrial arrhythmia. Results The search strategy yielded 57 trial arms from 56 randomized controlled trials comprising 5322 patients: 36 arms of patients with paroxysmal AF (PAF), and 21 arms of patients with persistent AF (PeAF) or both PAF/PeAF. Intermittent monitoring was associated with detection of significantly less atrial arrhythmia recurrence than continuous monitoring in PAF arms (31.2% vs 46.9%, P = 0.001), but not in PeAF/PAF-PeAF combined arms (43.3% vs 63.6%, P = 0.12). No significant relationship was seen between the duration of intermittent rhythm monitoring and atrial arrhythmia recurrence detection in either the PAF (P = 0.93) or PeAF/PAF-PeAF combined arms (P = 0.20). Conclusions Continuous rhythm monitoring detected higher atrial arrhythmia recurrence rates, compared to intermittent rhythm monitoring, in patients with PAF. The duration of intermittent monitoring did not show a statistically significant relationship to the yield of arrhythmia detection, in near identical cohorts of trial subjects undergoing similar interventions, with clinical and research implications.
Collapse
|
16
|
Jung RG, Di Santo P, Clifford C, Prosperi-Porta G, Skanes S, Hung A, Parlow S, Visintini S, Ramirez FD, Simard T, Hibbert B. Methodological quality of COVID-19 clinical research. Nat Commun 2021; 12:943. [PMID: 33574258 PMCID: PMC7878793 DOI: 10.1038/s41467-021-21220-5] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 01/13/2021] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 pandemic began in early 2020 with major health consequences. While a need to disseminate information to the medical community and general public was paramount, concerns have been raised regarding the scientific rigor in published reports. We performed a systematic review to evaluate the methodological quality of currently available COVID-19 studies compared to historical controls. A total of 9895 titles and abstracts were screened and 686 COVID-19 articles were included in the final analysis. Comparative analysis of COVID-19 to historical articles reveals a shorter time to acceptance (13.0[IQR, 5.0–25.0] days vs. 110.0[IQR, 71.0–156.0] days in COVID-19 and control articles, respectively; p < 0.0001). Furthermore, methodological quality scores are lower in COVID-19 articles across all study designs. COVID-19 clinical studies have a shorter time to publication and have lower methodological quality scores than control studies in the same journal. These studies should be revisited with the emergence of stronger evidence. During the early phase of the COVID-19 pandemic there was a need for rapid dissemination of clinical findings. Here, Jung, Di Santo et al. perform a systematic review and cohort study providing evidence for lower methodological quality scores and faster time to publication of clinical studies related to COVID-19 than comparable studies.
Collapse
Affiliation(s)
- Richard G Jung
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.,Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.,Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Pietro Di Santo
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.,Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.,Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Cole Clifford
- Faculty of Medicine, University of Ottawa, Ontario, Canada
| | | | | | - Annie Hung
- Division of Internal Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Simon Parlow
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Sarah Visintini
- Berkman Library, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - F Daniel Ramirez
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.,Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.,Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Bordeaux-Pessac, France.,L'Institut de Rythmologie et Modélisation Cardiaque (LIRYC), University of Bordeaux, Bordeaux, France
| | - Trevor Simard
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.,Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.,Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.,Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Benjamin Hibbert
- Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. .,Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. .,Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| |
Collapse
|
17
|
Rooprai J, Chan E, Rodger J, Visintini S, Rodger N, Mielniczuk L, Sun L. Sex-Based Differences in Outpatient Specialist Referral Patterns of Heart Failure Patients: A Scoping Review. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2020.02.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
18
|
Jung RG, Simard T, Di Santo P, Dhaliwal S, Sypkes C, Duchez AC, Moreland R, Taylor K, Parlow S, Visintini S, Labinaz A, Marbach J, Sarathy K, Bernick J, Joseph J, Boland P, Abdel-Razek O, Harnett DT, Ramirez FD, Hibbert B. Evaluation of plasminogen activator inhibitor-1 as a biomarker of unplanned revascularization and major adverse cardiac events in coronary angiography and percutaneous coronary intervention. Thromb Res 2020; 191:125-133. [PMID: 32447094 DOI: 10.1016/j.thromres.2020.04.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 03/18/2020] [Revised: 03/30/2020] [Accepted: 04/20/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The stented coronary artery remains at high-risk of complications, particularly in the form of stent thrombosis and in-stent restenosis. Improving our ability to identify patients at high-risk for these complications may provide opportunities for intervention. PAI-1 has been implicated in the pathophysiology of stent complications in preclinical studies, suggesting it may be a clinically valuable biomarker to predict adverse events following percutaneous coronary intervention. METHODS Plasma PAI-1 levels were measured in 910 subjects immediately after coronary angiography between 2015 and 2019. The primary outcome was the incidence of unplanned revascularization (UR) at 12 months. The secondary outcome was the incidence of major adverse cardiac events (MACE). RESULTS UR and MACE occurred in 49 and 103 patients in 12 months. Reduced plasma PAI-1 levels were associated with UR (4386.1 pg/mL [IQR, 2778.7-6664.6], n = 49, vs. 5247.6 pg/mL [IQR, 3414.1-7836.1], n = 861; p = 0.04). Tertile PAI-1 levels were predictive of UR after adjustment for known clinical risk factors associated with adverse outcomes. In post-hoc landmark analysis, UR was enhanced with low plasma PAI-1 levels for late complications (beyond 30 days). Finally, an updated systematic review and meta-analysis did not reveal an association between plasma PAI-1 and MACE. CONCLUSION PAI-1 levels are not independently associated with UR nor MACE in patients undergoing angiography but associated with UR following adjustment with known clinical factors. In our landmark analysis, low PAI-1 levels were associated with UR for late stent complications. As such, future studies should focus on the mediatory role of PAI-1 in the pathogenesis of stent complications.
Collapse
Affiliation(s)
- Richard G Jung
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Trevor Simard
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Pietro Di Santo
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Shan Dhaliwal
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Department of Biochemistry, Microbiology, and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Caleb Sypkes
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Robert Moreland
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Katlyn Taylor
- Department of Pharmacy, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Simon Parlow
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Division of Internal Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Sarah Visintini
- Berkman Library, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Alisha Labinaz
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Jeffrey Marbach
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Kiran Sarathy
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Jordan Bernick
- Ottawa Cardiovascular Research Methods Center, Ottawa, Ontario, Canada
| | - Joanne Joseph
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Division of Internal Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Paul Boland
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Omar Abdel-Razek
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - David T Harnett
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - F Daniel Ramirez
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Bordeaux-Pessac, France; L'Institut de Rythmologie et Modélisation Cardiaque (LIRYC), University of Bordeaux, France
| | - Benjamin Hibbert
- CAPITAL Research Group, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| |
Collapse
|
19
|
Prince SA, Elliott CG, Scott K, Visintini S, Reed JL. Device-measured physical activity, sedentary behaviour and cardiometabolic health and fitness across occupational groups: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2019; 16:30. [PMID: 30940176 PMCID: PMC6444868 DOI: 10.1186/s12966-019-0790-9] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/08/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND With approximately 8 hours of one's waking day spent at work, occupational tasks and environments are important influencers on an individual's physical activity (PA) and sedentary behaviours. Little research has compared device-measured physical activity, sedentary behaviour and cardiometabolic outcomes between occupational groups. OBJECTIVE To compare device-measured movement (sedentary time [ST], light intensity physical activity [LPA], moderate-to-vigorous intensity physical activity [MVPA], and steps) across occupations. The secondary objective was to examine whether cardiometabolic and fitness outcomes differed by occupation. METHODS Five bibliographic databases were searched to identify all studies which included working age, employed adults from high-income countries, and reported on device-measured movement within occupations. Risk of bias within and across studies was assessed. Results were synthesized using meta-analyses and narrative syntheses. RESULTS The review includes 132 unique studies with data from 15,619 participants. Working adults spent ~ 60% of their working and waking time engaged in sedentary behaviour; a very small proportion (~ 4%) of the day included MVPA. On average, workers accumulated 8124 steps/day. Office and call center workers' steps/day were among the lowest, while those of postal delivery workers were highest. Office workers had the greatest ST and the lowest time in LPA both at work and during wakeful time. However, office workers had the greatest minutes sent in MVPA during wakeful hours. Laborers had the lowest ST and spent a significantly greater proportion of their work time in LPA and MVPA. Healthcare and protective services workers had higher levels of LPA at work compared to other occupations. Workers in driving-based occupations tended to have a higher body mass index and blood pressure. CONCLUSION This review identifies that occupational and wakeful time PA and ST differed between occupations. Future studies are needed to assess whether patterns differ by age and sex, describe leisure-time movement and movement patterns, and the relationship with cardiometabolic health. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017070448 .
Collapse
Affiliation(s)
- Stephanie A. Prince
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 Canada
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada
| | - Cara G. Elliott
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 Canada
| | - Kyle Scott
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Sarah Visintini
- Berkman Library, University of Ottawa Heart Institute, Ottawa, Canada
| | - Jennifer L. Reed
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| |
Collapse
|
20
|
Russo J, Aleksova N, Pitcher I, Faraz M, Couture E, Parlow S, Visintini S, Simard T, Boland P, Di Santo P, Marbach J, Ramirez F, So D, Labinaz M, Le May M, Hibbert B. TCT-697 Left ventricular decompression during extracorporeal membrane oxygenation for cardiogenic shock: A systematic review and meta-analysis. J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2018.08.1912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
21
|
Abstract
Background:As part of a health sciences library’s internal assessment of its research support services, an environmental scan and literature review were conducted to identify research services offered elsewhere in Canada. Through this process, it became clear that a more formal review of the academic literature would help libraries make informed decisions about their services. To address this gap, we conducted a scoping review of research services provided in health sciences libraries contexts.Methods:Searches were conducted in Medline, Embase, ERIC, CINAHL, LISTA, LISS, Scopus, Web of Science, Google Scholar and Google for articles which described the development, implementation, or evaluation of one or more research support initiatives in a health sciences library context. We identified additional articles by searching reference lists of included studies and soliciting medical library listservs.Results:Our database searches retrieved 7134 records, 4026 after duplicates were removed. Title/abstract screening excluded 3751, with 333 records retained for full-text screening. Seventy-five records were included, reporting on 74 different initiatives. Included studies were published between 1990 and 2017, the majority from North American and academic library contexts. Major service areas reported were the creation of new research support positions, and support services for systematic review support, grants, data management, open access and repositories.Conclusion:This scoping review is the first review to our knowledge to map research support services in the health sciences library context. It identified main areas of research service support provided by health sciences libraries that can be used for benchmarking or information gathering purposes.
Collapse
|
22
|
Jung RG, Motazedian P, Ramirez FD, Simard T, Di Santo P, Visintini S, Faraz MA, Labinaz A, Jung Y, Hibbert B. Association between plasminogen activator inhibitor-1 and cardiovascular events: a systematic review and meta-analysis. Thromb J 2018; 16:12. [PMID: 29991926 PMCID: PMC5987541 DOI: 10.1186/s12959-018-0166-4] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 03/05/2018] [Indexed: 12/17/2022] Open
Abstract
Background Small studies have implicated plasminogen activator inhibitor-1 (PAI-1) as a predictor of cardiovascular events; however, these findings have been inconsistent. We sought out to examine the potential role of PAI-1 as a marker for major adverse cardiovascular events (MACE). Methods We systematically reviewed all indexed studies examining the association between PAI-1 and MACE (defined as death, myocardial infarction, or cerebrovascular accident) or restenosis. EMBASE, Web of Science, Medline, and the Cochrane Library were searched through October 2016 to identify relevant studies, supplemented by letters to authors and review of citations. Studies reporting the results of PAI-1 antigen and/or activity levels in association with MACE in human subjects were included. Results Of 5961 articles screened, we identified 38 articles published between 1991 to 2016 that reported PAI-1 levels in 11,557 patients. In studies that examined PAI-1 antigen and activity levels, 15.1% and 29.6% of patients experienced MACE, respectively. Patients with MACE had higher PAI-1 antigen levels with a mean difference of 6.11 ng/mL (95% CI, 3.27-8.96). This finding was similar among patients with and without known coronary artery disease. Comparatively, studies that stratified by PAI-1 activity levels were not associated with MACE. In contrast, studies of coronary restenosis suggest PAI-1 antigen and activity levels are negatively associated with MACE. Conclusions Elevated plasma PAI-1 antigen levels are associated with MACE. Definitive studies are needed to ascertain if PAI-1 acts simply as a marker of risk or if it is indeed a bona fide therapeutic target. Electronic supplementary material The online version of this article (10.1186/s12959-018-0166-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Richard G Jung
- 1CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, ON K1Y 4W7 Canada.,2Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON Canada.,3Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, ON Canada
| | - Pouya Motazedian
- 1CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, ON K1Y 4W7 Canada
| | - F Daniel Ramirez
- 1CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, ON K1Y 4W7 Canada.,4Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON Canada.,5School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON Canada
| | - Trevor Simard
- 1CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, ON K1Y 4W7 Canada.,2Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON Canada.,3Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, ON Canada.,4Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON Canada
| | - Pietro Di Santo
- 1CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, ON K1Y 4W7 Canada.,4Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON Canada
| | - Sarah Visintini
- 6Berkman Library, University of Ottawa Heart Institute, Ottawa, ON Canada
| | - Mohammad Ali Faraz
- 1CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, ON K1Y 4W7 Canada
| | - Alisha Labinaz
- 1CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, ON K1Y 4W7 Canada
| | - Young Jung
- 7Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON Canada
| | - Benjamin Hibbert
- 1CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, ON K1Y 4W7 Canada.,2Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON Canada.,3Vascular Biology and Experimental Medicine Laboratory, University of Ottawa Heart Institute, Ottawa, ON Canada.,4Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON Canada
| |
Collapse
|
23
|
Landers AL, McLuckie A, Cann R, Shapiro V, Visintini S, MacLaurin B, Trocmé N, Saini M, Carrey NJ. A scoping review of evidence-based interventions available to parents of maltreated children ages 0-5 involved with child welfare services. Child Abuse Negl 2018; 76:546-560. [PMID: 28985958 DOI: 10.1016/j.chiabu.2017.09.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 09/05/2017] [Accepted: 09/10/2017] [Indexed: 06/07/2023]
Abstract
Parents referred to child welfare services for child maltreatment often struggle against chronic risk factors including violence, substance abuse, mental health concerns, and poverty, which impinge upon their ability to be sensitive caregivers. The first line of intervention within the child welfare context is to modify parenting behavior. This scoping review comprehensively surveyed all available literature to map the extent and range of research activity around the types of interventions available within a child welfare context to parents of infants and toddlers (0-5 years of age), to identify the facilitators and/or barriers to the uptake of interventions, and to check that interventions match the risk factors faced by parents. This scoping review engaged in stringent screening of studies based upon inclusion/exclusion criteria. Sixty-five articles involving forty-two interventions met inclusion criteria. Interventions generally aimed to improve parenting practices, the relationship between parent and child, and/or attachment security, along with reducing child abuse and/or neglect. A notable finding of this scoping review is that at present, interventions for parents of children ages 0-5 involved with the child welfare system are most frequently measured via case study and quasi-experimental designs, with randomized control trials making up 26.2% of included study designs.
Collapse
Affiliation(s)
- Ashley L Landers
- Virginia Polytechnic Institute & State University, United States.
| | | | - Robin Cann
- IWK Health Centre, Halifax, Nova Scotia, Canada
| | | | | | | | | | | | | |
Collapse
|
24
|
Prince SA, McDonnell LA, Turek MA, Visintini S, Nahwegahbow A, Kandasamy S, Sun LY, Coutinho T. The State of Affairs for Cardiovascular Health Research in Indigenous Women in Canada: A Scoping Review. Can J Cardiol 2017; 34:437-449. [PMID: 29439893 DOI: 10.1016/j.cjca.2017.11.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 11/10/2017] [Accepted: 11/19/2017] [Indexed: 12/19/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death among Indigenous peoples in Canada. As rates of CVD rise, the impacts among the growing population of Indigenous women will emerge as an important health issue. The objective of this scoping review was to advance the state of knowledge about cardiovascular health research in Indigenous women in Canada. Five databases and grey literature (non-peer reviewed works) were searched to identify all studies that reported on the prevalence, pathophysiology, diagnosis, treatment, or interventions for CVD among adult Indigenous women in Canada, including First Nations, Métis, and Inuit. Searching identified 3194 potential articles; 61 of which were included. The most commonly researched topics were the prevalence of CVD, hypertension, and dyslipidemia. Rates of CVD and associated mortality among Indigenous women appear to have surpassed those of their nonindigenous counterparts. Very little research has examined the pathophysiology, diagnosis, and treatment of CVD. Gaps in the research identified the need for sex-based analyses, comparison with nonindigenous women, comprehensive longitudinal data, assessment of diagnosis criteria, development and evaluation of cardiovascular health interventions, and a better understanding of the role of culture and traditions in the prevention and treatment of CVD among Indigenous women. Although comprehensive CVD data are lacking, rates of CVD among Indigenous women in Canada are rising and are nearing or surpassing those of nonindigenous women. This review serves as a call to action to seek further research on the pathophysiology, diagnosis, and treatment of CVD among Indigenous women from across Canada.
Collapse
Affiliation(s)
- Stephanie A Prince
- Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| | - Lisa A McDonnell
- Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Michele A Turek
- Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Division of Cardiology, The Ottawa Hospital, Ottawa, Ontario, Canada; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Sarah Visintini
- Berkman Library, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | | | - Sujane Kandasamy
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Louise Y Sun
- Division of Cardiac Anesthesiology, Department of Anesthesiology and Pain Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Cardiovascular Research Program, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Thais Coutinho
- Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| |
Collapse
|
25
|
Rhee C, Visintini S, Dunning CE, Oxner WM, Glennie RA. Does restoration of focal lumbar lordosis for single level degenerative spondylolisthesis result in better patient-reported clinical outcomes? A systematic literature review. J Clin Neurosci 2017; 44:95-100. [DOI: 10.1016/j.jocn.2017.06.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 06/19/2017] [Indexed: 11/27/2022]
|
26
|
La Corte E, Patanè M, Campisi GM, Paroni RC, Serrao G, Milanesi IM, Visintini S, Ferroli P, Ghidoni R, Pollo B. P03.13 Molecular and clinical bio-markers in a series of 48 consecutive skull base chordoma patients. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
27
|
Valentini L, Solero CL, Lasio G, Giombini S, Visintini S, Balestrini MR, Giordano L, Grisoli M. Triventricular hydrocephalus: review of 71 cases evaluated at the Istituto Neurologico "C. Besta" Milan over the last 10 years. Childs Nerv Syst 1995; 11:170-2. [PMID: 7773978 DOI: 10.1007/bf00570259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The authors review 71 patients with triventricular hydrocephalus in whom a contrast-enhanced CT scan did not show any tumoral or vascular lesion that could have caused the hydrocephalus. The patients were subdivided into three age groups. The results of the neuroradiological examination, the surgical treatment, and the complications of the shunt procedure are analyzed, with special reference to the high number (13) of periaqueductal alterations of signal pattern found on MRI (interpreted as a "slow growing" neoplasm) and to the incidence and causes of shunt malfunction.
Collapse
Affiliation(s)
- L Valentini
- Department of Neurosurgery, Istituto Neurologico C. Besta, Milan, Italy
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Abstract
We describe 3 patients, who exhibited neurological symptoms after single dose epidural anaesthesia. In patient 1 an unrecognized spinal arteriovenous fistula (AVF) caused paraparesis following epidural block. The dilated veins draining an AVF are space-occupying structures and the injection of the anaesthetic solution may have precipitated latent ischaemic hypoxia of the spinal cord due to raised venous pressure. In patient 2, epidural block was followed by postoperative permanent saddle pain and hypoaesthesia. The injection of the anaesthetic in a narrow spinal canal with multiple discal protrusions and restriction of interlaminar foramina may have acutely produced mechanical compression of the spinal cord or roots. Patient 3 exhibited post-epidural block spinal arachnoiditis. Although the few reported cases of this syndrome exhibit severe neurological damage, our patient presented with scarse symptoms. Our cases point out the importance of accurate neurological history and examination of candidates for epidural anaesthesia and of accurate anaesthetic history for neurological patients.
Collapse
Affiliation(s)
- M Gemma
- Department of Neuroanesthesia and Intensive Care, National Neurological Institute of Milan C. Besta, Italy
| | | | | | | | | | | |
Collapse
|
29
|
Broggi G, Servello D, Franzini A, Giorgi C, Visintini S. Epidural stimulation for peripheral vascular disease: 10 years experience. Ital J Neurol Sci 1993; 14:317-20. [PMID: 8325769 DOI: 10.1007/bf02339298] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
105 patients suffering from arteriosclerotic peripheral vascular disease (PVD) underwent epidural spinal stimulation in the last 10 years. Before 1986 the main indication was ischemic pain without any consideration of trophic lesions (19 pts) while afterward the selection of the patients was more accurate in terms of disease's stage. The analysis of the data shows a more favourable results in the second group. Our experience suggest to use this technique in the treatment of patients in Fontaine's stage III and IV without necrosis and large trophic lesions.
Collapse
Affiliation(s)
- G Broggi
- Divisione di Neurochirurgia, Istituto Nazionale Neurologico C. Besta, Milano
| | | | | | | | | |
Collapse
|
30
|
Fornari M, Solero CL, Lasio G, Lodrini S, Balestrini MR, Cimino C, Visintini S, Pluchino F. Surgical treatment of intracranial dermoid and epidermoid cysts in children. Childs Nerv Syst 1990; 6:66-70. [PMID: 2340530 DOI: 10.1007/bf00307923] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Between 1956 and 1987 operations were performed on 36 patients below the age of 20 years for epidermoid and dermoid cysts of the central nervous system. Seventeen tumors were intracranial intradural lesions (47%): 12 were located in the supratentorial region (71%) and 5 were located in the infratentorial region (29%). Ten of these tumors (59%) were seated along the midline structures. The clinical presentation was consistent with the location of the tumors. The neuroradiological diagnosis was mostly made with the aid of pneumoencephalography, computed tomography (CT), nonionic contrast medium CT cisternography, and magnetic resonance imaging. Complete removal of the tumor contents was performed in all cases but one, although the completeness of removal of the tumor capsule could not be exactly estimated in some patients. At late follow-up only two tumor recurrences were observed. Radical removal of the tumor capsule of these congenital tumors, even when it is connected to vital neurovascular structures, seems advisable in patients who become symptomatic within the first two decades of life.
Collapse
Affiliation(s)
- M Fornari
- Department of Neurosurgery, Istituto Neurologico C. Besta, Milan, Italy
| | | | | | | | | | | | | | | |
Collapse
|