scholarly journals The Prognostic Significance of the Alterations of Cardiovascular Hemodynamics in Patients With Pulmonary Arterial Hypertension: A Meta-regression Analysis of Randomized Controlled Trials

2021 ◽  
Author(s):  
Shih-Hsien Sung ◽  
Wan-Yu Yeh ◽  
Chern-En Chiang ◽  
Chi-Jung Huang ◽  
Wei-Ming Huang ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Pulmonary Arterial Hypertension ◽  
Explanatory Power ◽  
Controlled Trials ◽  
Hemodynamic Changes ◽  
Randomized Controlled ◽  
Clinical Events ◽  
Pulmonary Arterial ◽  
Meta Regression ◽  
Meta Regression Analysis

Abstract Background: Hemodynamic assessment in patients with pulmonary arterial hypertension (PAH) is essential for risk stratification and pharmacological management. However, the prognostic value of the hemodynamic changes after treatment is less well established. Objectives: We investigated the prognostic impacts of the changes in hemodynamic indices, including mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), right atrial pressure (RAP) and cardiac output index (CI). We conducted this systematic review with meta-regression analysis on existing clinical trials.Methods:We searched and identified all relevant randomized controlled trials from multiple databases. An analogous R2 index was used to quantify the proportion of variance explained by each predictor in the association with PAH patients’ prognosis. A total of 20 trials and 3,263 individuals were enrolled. Results:The changes in mPAP, PVR, RAP and CI were all significantly associated with the change in 6MWD (∆6MWD). The change in mPAP was with the highest explanatory power for ∆6MWD (R2 analog=0.739). Additionally, the changes in mPAP, PVR and CI were independently predictive of adverse clinical events. The change in mPAP had the highest explanatory power for the clinical events (R2 analog =0.911). Furthermore, the change in PVR was with the highest explanatory power for total mortality of PAH patients (R2 analog =0.594). Conclusion:Hemodynamic changes after treatment, including mPAP, PVR, CI and RAP, were significantly associated with adverse clinical events or mortality in treated PAH patients. It is recommended that further studies be conducted to evaluate the changes in hemodynamic indices to guide drug titration.Trial registration number: PROSPERO; No.: CRD42019125157; URL: https://www.crd.york.ac.uk/PROSPERO/ (Date of registration: 14/03/2019)

scholarly journals The prognostic significance of the alterations of pulmonary hemodynamics in patients with pulmonary arterial hypertension: a meta-regression analysis of randomized controlled trials

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Shih-Hsien Sung ◽  
Wan-Yu Yeh ◽  
Chern-En Chiang ◽  
Chi-Jung Huang ◽  
Wei-Ming Huang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Regression Analysis ◽  
Explanatory Power ◽  
Controlled Trials ◽  
Hemodynamic Changes ◽  
Randomized Controlled ◽  
Clinical Events ◽  
Pulmonary Arterial ◽  
Meta Regression ◽  
Meta Regression Analysis

Abstract Background Hemodynamic assessment in patients with pulmonary arterial hypertension (PAH) is essential for risk stratification and pharmacological management. However, the prognostic value of the hemodynamic changes after treatment is less well established. Objectives We investigated the prognostic impacts of the changes in hemodynamic indices, including mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), right atrial pressure (RAP), and cardiac output index (CI). We conducted this systematic review with meta-regression analysis on existing clinical trials. Methods We searched and identified all relevant randomized controlled trials from multiple databases. An analogous R2 index was used to quantify the proportion of variance explained by each predictor in the association with PAH patients’ prognosis. A total of 21 trials and 3306 individuals were enrolled. Results The changes in mPAP, PVR, RAP, and CI were all significantly associated with the change in 6MWD (∆6MWD). The change in mPAP was with the highest explanatory power for ∆6MWD (R2 analog = 0.740). Additionally, the changes in mPAP, PVR, and CI were independently predictive of adverse clinical events. The change in mPAP had the highest explanatory power for the clinical events (R2 analog = 0.911). Furthermore, the change in PVR was with the highest explanatory power for total mortality of PAH patients (R2 analog = 0.612). Conclusion Hemodynamic changes after treatment, including mPAP, PVR, CI, and RAP, were significantly associated with adverse clinical events or mortality in treated PAH patients. It is recommended that further studies be conducted to evaluate the changes in hemodynamic indices to guide drug titration. Systematic review registration PROSPERO CRD42019125157

scholarly journals SOFA and mortality endpoints in randomized controlled trials: a systematic review and meta-regression analysis

Critical Care ◽  
2017 ◽  
Vol 21 (1) ◽  
Author(s):  
Harm-Jan de Grooth ◽  
Irma L. Geenen ◽  
Armand R. Girbes ◽  
Jean-Louis Vincent ◽  
Jean-Jacques Parienti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Regression Analysis ◽  
Randomized Controlled Trials ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Meta Regression ◽  
Meta Regression Analysis

Statins and Cancer Risk: A Literature-Based Meta-Analysis and Meta-Regression Analysis of 35 Randomized Controlled Trials

2006 ◽  
Vol 24 (30) ◽  
pp. 4808-4817 ◽  
Author(s):  
Stefanos Bonovas ◽  
Kalitsa Filioussi ◽  
Nikolaos Tsavaris ◽  
Nikolaos M. Sitaras
Keyword(s):  
Regression Analysis ◽  
Cancer Risk ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Meta Regression ◽  
Meta Regression Analysis ◽  
Risk Of Cancer ◽  
Statin Use

Purpose A growing body of literature suggests that statins may have chemopreventive potential against cancer. Our aim was to examine the strength of this association through a detailed meta-analysis and meta-regression analysis of randomized controlled trials (RCTs). Methods A comprehensive search for trials published up to 2005 was performed, reviews of each study were conducted, and data were abstracted. Before meta-analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk (RR) estimates and 95% CIs were calculated using the random- and fixed-effects models. Subgroup, sensitivity, and meta-regression analyses were also conducted. Results Thirty-five RCTs of statins for cardiovascular outcomes contributed to the analysis (n = 109,143). The degree of variability between trials was consistent with what would be expected to occur by chance alone. Statin use was not associated with a substantially increased or decreased overall risk of cancer (RR = 0.99; 95% CI, 0.94 to 1.04). Similarly, statin use did not significantly affect respiratory cancer risk (RR = 0.95; 95% CI, 0.83 to 1.09). However, the meta-regression analysis indicated that age of study participants modified the association between statin use and cancer risk (P = .003). Conclusion Our findings do not support a protective effect of statins against cancer. However, this conclusion is limited by the relatively short follow-up periods (4.5 years on average) of the studies analyzed. Thus, it is important to continue monitoring the long-term safety profiles of statins. Until then, physicians need to be vigilant in ensuring that statin use remains restricted to the approved indications.

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