Risultati per: Il dolore neuropatico: review

Circulation, Volume 150, Issue Suppl_1, Page A4144538-A4144538, November 12, 2024. Background:Postural Orthostatic Tachycardia Syndrome (POTS) is a condition characterized by an excessive increase in heart rate upon standing and other autonomic symptoms. Optimal treatments for this disease are still under research. Ivabradine, a selective inhibitor of the If channel, has emerged as a potential treatment for POTS due to its ability to reduce heart rate without affecting blood pressure. In this context, we conducted a systematic review and meta-analysis to assess the impact of ivabradine on Symptoms in POTS patients.Methods:We systematically searched Pubmed, Embase, and Cochrane databases for studies assessing the efficacy and safety of ivabradine in patients with POTS. We calculated event prevalence for binary outcomes and mean value for continuous outcomes, along with 95% confidence intervals (CI). Statistical analysis was performed using R version 4.3.2. A random-effects model was used for all outcomes, and heterogeneity was assessed with Cochrane’s Q and I2 statisticsResults:We included ten studies, comprising 267 patients, of whom 130 (48.68%) were females, with a mean age of 34,68 years, and the heart rate (HR) before ivabradine use ranged between 94.20 and 117.66 bpm. The analysis showed an improvement of symptoms in 90.89% (95% CI: 80.34-98.07;) of patients, and a decrease of 14.46 bpm in HR (95% CI: 7.69-21.24; ), which ranged between 79.82 and 98.25 bpm (95% CI; ). Additionally, we observed side effects events in 9.58% of patients (95% CI: 3.69-17.30;).Conclusion:In patients with POTS, ivabradine appears to be a viable treatment option. Further comparative and more powerful studies are necessary to assess the efficacy and safety of ivabradine in this population.

Circulation, Volume 150, Issue Suppl_1, Page A4144446-A4144446, November 12, 2024. Introduction:Empagliflozin, a sodium–glucose co-transporter-2 (SGLT-2) inhibitor, improves cardiovascular outcomes in patients with heart failure (HF) with or without diabetes mellitus. However, limited data is available regarding its impact after acute myocardial infarction (AMI). Therefore, we aimed in our meta-analysis to evaluate the safety and efficacy of empagliflozin after AMI.Methods:We searched PubMed, Scopus, Cochrane Library, and Web of Science from inception to April 19th, 2024, to identify any Randomized Controlled trials (RCTs) that compare empagliflozin to placebo after AMI. The safety outcomes were presented as short term cardiovascular mortality, all-cause mortality, hospitalization for heart failure (HF), and any adverse events. The efficacy outcomes were reported as NT-proBNP, systolic blood pressure (SBP), diastolic blood pressure (DBP), and LDL-c. Dichotomous outcomes were pooled in the form of risk ratio (RR), and continuous outcomes in form of mean difference (MD), with the corresponding 95% confidence intervals (CI).Results:Ten RCTs with a total of 10,697 patients were included. Empagliflozin was associated with significant lower risk of cardiovascular mortality (RR = 0.57, 95% CI [0.46, 0.71]), all cause mortality, and hospitalization for heart failure, (RR=0.64, 95% CI [0.53, 0.79]), (RR = 0.67, 95% CI [0.58, 0.79]), respectively. Furthermore, empagliflozin demonstrated a significant reduction in both NT-proBNP (MD = -161.26, 95% CI [-294.58, -27.93]) and SBP (MD= -8.59, 95% CI [-13.26, -3.93]). However, there is no difference between the two groups in terms of any adverse events, diastolic blood pressure, and LDL-c, (RR=0.98, 95% CI [0.95, 1.02]), (MD = -2.55, 95% CI [-5.31,0.20]), (MD=1.67, 95% CI [-6.11, 9.46]), respectively.Conclusion:Our meta analysis reveals that empagliflozin significantly reduce all major cardiovascular outcomes after AMI such as cardiovascular mortality and hospitalization due to heart failure. Moreover, empagliflozin effectively lowers NT-proBNP levels and SBP with no superiority in terms of adverse events, diastolic blood pressure and LDL-c.

Circulation, Volume 150, Issue Suppl_1, Page A4144763-A4144763, November 12, 2024. Background:Anemia is frequently observed as a comorbidity in atrial fibrillation (AF) and is associated with poor clinical outcomes.Purpose:We aim to investigate the impact of anemia on clinical outcomes in AF Patients on oral anticoagulants.Methods:We comprehensively searched PubMed, WOS, SCOPUS, EMBASE, and CENTRAL through March 2024 and conducted a prognostic systematic review and meta-analysis. All analyses were performed using R V. 4.3.1.Results:With the inclusion of 23 studies, our cohort comprised a total of 286,781 patients. Anemia was significantly associated with an 86% increase in the risk of major bleeding (HR: 1.86 with 95% CI [1.61, 2.14], P< 0.01), a 25% increase in the risk of intracranial hemorrhage (HR: 1.25 with 95% CI [1.02, 1.54], P= 0.03), a 92% increase in the risk of gastrointestinal bleeding (HR: 1.92 with 95% CI [1.68, 2.19], P< 0.01), and a 91% increase in the risk of all-cause mortality (HR: 1.91 with 95% CI [1.46, 2.51], P< 0.01). However, Anemia did not significantly affect the risk of stroke, TIA, or systemic embolism (HR: 1.07 with 95% CI [0.93, 1.22], P= 0.36).Conclusion:Anemia was significantly associated with an increased risk of major bleeding, intracerebral hemorrhage, gastrointestinal bleeding, and all-cause mortality without impacting stroke, TIA, or systemic embolism. Further research is warranted to compare the effects of DOACs and vitamin K antagonists. Clinically, it is imperative to closely monitor the anemic status of patients due to these elevated risks.

Circulation, Volume 150, Issue Suppl_1, Page A4148117-A4148117, November 12, 2024. Background:Tricuspid regurgitation (TR) is a prevalent disease in the population and is usually progressive. Most patients are treated with conservative management due to the risk involving transcatheter tricuspid valve replacement (TTVR) and surgical tricuspid valve replacement (STVR). The TRI-SCORE was developed to evaluate the severity of patients with TR and their risk of undergoing a correction procedure. However, there is still controversy regarding the cutoff value of the score. Therefore, we aim to perform a systematic review and meta-analysis comparing the cutoffs ≥6 with =6 with

Circulation, Volume 150, Issue Suppl_1, Page A4148133-A4148133, November 12, 2024. Background:Left ventricular assist devices (LVADs) are crucial for the management of advanced heart failure patients acting, both as a bridge to heart transplant or destination therapy. Existing studies revealed mixed results on the impact of pre-implant left ventricular end-diastolic diameter (LVEDD) on post-LVAD mortality. Some studies found smaller LVEDD increases mortality, while others revealed no significant impact. Due to the limited evidence, this meta-analysis aims to determine the association between pre-LVEDD and post-LVAD implantation mortality through a systematic review and meta-analysis.Method:We systematically reviewed articles until May 2024 examining the association between pre-implant LVEDD and post-LVAD implantation mortality using PubMed, Google Scholar, Embase, and Scopus. A random effects model was used to calculate the pooled adjusted odds ratio (aOR). We used I2statistics to determine the heterogeneity of studies. Leave-one-out sensitivity analysis was done to evaluate each study’s effect on the overall estimate, with statistical significance set at p

Circulation, Volume 150, Issue Suppl_1, Page A4147724-A4147724, November 12, 2024. Background:ST-Elevation Myocardial Infarction (STEMI) has a huge clinical burden globally. Pre-administration of Nicorandil before primary percutaneous coronary intervention for STEMI has demonstrated efficacy in enhancing microvascular recovery and reducing reperfusion injury in RCTs. Consequently, Nicorandil exhibits potential in providing considerable cardioprotective advantage in STEMI patients.Aims:Nicorandil therapy is being extensively investigated as a treatment for reperfusion injury associated with primary percutaneous coronary intervention. This meta-analysis evaluates various studies to determine the cardioprotective effects of nicorandil, with particular emphasis on its influence on infarct size.Methods:MEDLINE (via PubMed), Scopus, Cochrane Library, and Google Scholar were systematically searched for relevant studies. Primary endpoint was infarct size. Left Ventricular End Diastolic volume, Left Ventricular End Systolic Volume, Left Ventricular Ejection Fraction (LVEF), Major Adverse Cardiovascular Events (MACE), and rehospitalizations were analysed as secondary end points. Review Manager 5.4 was used to pool mean differences (MD) and Risk Ratios (RR) along with their 95% Confidence Intervals (CI).Results:3 RCTs including a total of 438 patients were included in our review. Compared with placebo, nicorandil therapy significantly reduced infarct size with a pooled MD of -3.20 (95% CI -5.25 to -1.14). There was also significant reduction in Left Ventricular End Systolic Volume (MD= -5.63; 95% CI -11.22 to -0.05) and a nonsignificant reduction in Left Ventricular End Diastolic Volume (MD= -6.37; 95% CI -12.74 to 0.01). Nicorandil therapy caused a nonsignificant decrease in MACE (RR=0.74; 95% CI 0.37 to 1.46) and readmission rate (RR=0.73; 95% CI 0.30 to 1.77) compared to placebo. It also caused a significant increase in the Left Ventricular Ejection Fraction (LVEF) with a pooled MD of 2.53 (95% CI 0.53-4.54).Conclusion:Pre-treatment with Nicorandil in STEMI patients being treated with primary percutaneous coronary intervention is associated with significant improvement in infarct size and cardiac systolic function.

Circulation, Volume 150, Issue Suppl_1, Page A4140260-A4140260, November 12, 2024. Introduction:New therapies for resistant hypertension (RH), including renal denervation (RDN), have been studied.Aim:Access the safety and effectiveness of radiofrequency-based RDN vs pharmacological treatment for RH.Methods:A thorough literature search was conducted across PubMed, EMBASE, and the Cochrane databases, focusing on studies that compared the effects of radiofrequency-based RDN versus pharmacological treatment for RH. Treatment effects for binary and continuous endpoints were pooled and used, respectively, odds-ratio (OR) and mean differences (MD) with 95% confidence intervals (CI) to analyze continuous outcomes.Results:All the 10 included studies were randomized controlled trials, they involved 1.182 patients, and 682 received radiofrequency-based RDN. The follow-up period ranged from 6 to 84 months. Analysis revealed that the RDN group had a significant reduction in office systolic blood pressure (BP) (MD: -9.5 mmHg; 95% CI: -16.81 to -2.29; P=0.01), office diastolic BP (MD: -5.1 mmHg; 95% CI: -8.42 to -2.80; P

Circulation, Volume 150, Issue Suppl_1, Page A4131100-A4131100, November 12, 2024. Background:Previous literature shows that metabolic surgery effectively decreases the risk of cardiovascular disease (CVD) events in patients with obesity. The use of metabolic surgery has, however, been limited in people with obesity and pre-existing CVD due to concerns of poor post-operative cardiovascular outcomes. This study aims to determine the effectiveness and safety of metabolic surgery in patients with pre-existing CVD.Methods:A search of electronic databases, PubMed, Cochrane Central and SCOPUS was conducted from their inception till May 2024. The study was conducted adhering to the PRISMA guidelines. Outcomes of interest were risk of all-cause mortality, major adverse cardiovascular events (MACE), risk of myocardial infarction (MI), and cerebrovascular events in patients with and without prior CVD undergoing bariatric surgery. Data was pooled as generic inverse variance using a random effects model, and presented as hazard ratios (HR) with their 95% confidence intervals (CI).Results:We included four studies in our analysis (n = 5,244). Our pooled analysis shows that metabolic surgery leads to significant reduction in risk of all-cause mortality (HR = 0.51, 95% CI: [0.42, 0.61]; p

Circulation, Volume 150, Issue Suppl_1, Page A4145774-A4145774, November 12, 2024. Introduction:Little is known about the outcomes of cancer survivors versus patients without a history of cancer undergoing Transcatheter Edge-to-Edge Mitral Valve Repair (TEER) for mitral regurgitation (MR). Moreover, recent publications retrieved conflicting results on the safety and efficacy of TEER in cancer survivors.Hypothesis:Performing TEER in cancer survivors produces similar outcomes when compared to patients with no history of cancer.Aims:Conduct a systematic review and meta-analysis to evaluate clinical outcomes after TEER for MR in patients with versus without a history of cancer.Methods:From inception to December 2023, we systematically searched PubMed, Web of Science, and Embase for studies comparing the safety and efficacy of TEER for MR in cancer survivors versus in patients without a history of cancer. Outcomes of interest were 30-day and 1-year all-cause mortality, incidence of post-procedural MR grade ≥ 3, post-procedural stroke, and 30-day readmissions. Statistical analyses were performed using R software version 4.3.2. We pooled odds ratios (OR) with 95% confidence intervals (CI) for binary endpoints.Results:We included six observational studies comprising 25,334 patients, of whom 6.1% were cancer survivors. Cancer survivors and controls had comparable rates of 30-day all-cause mortality (OR 1.15; 95% CI 0.55 to 2.39; p=0.71), 1-year all-cause mortality (OR 1.61; 95% CI 0.93 to 2.79; p=0.09), post-procedure severe MR (OR 1.49; 95% CI 0.67 to 3.30; p=0.33), post-procedural stroke (OR 1.25; 95% CI 0.47 to 3.27; p=0.66), and 30-day readmission (OR 1.16; 95% CI 0.92 to 1.46; p=0.19).Conclusion:This meta-analysis suggests that cancer survivors with symptomatic MR have similar outcomes after TEER as compared with patients who do not have a history of cancer. Future multicenter studies are warranted to confirm and expand these findings in larger populations and with multivariable-adjusted analysis.

Circulation, Volume 150, Issue Suppl_1, Page A4145107-A4145107, November 12, 2024. Background:Kounis syndrome (KS), also known as allergic myocardial infarction, is a rare but potentially life-threatening condition characterized by acute coronary syndrome in the setting of allergic reactions triggered by drugs, foods, vaccines, or environmental exposure. Our study provides an updated comprehensive insight into this patient cohort on a large scale.Methods:We conducted a systemic literature search in PubMed, EMBASE, and Google Scholar between 2018 and 2024, using MeSH terms and keywords for “Kounis syndrome”, “drug”, and allergy to identify the cases of drug-induced KS. Initial search yielded 325 articles. After excluding duplicates, review articles and irrelevant studies, we included only 51 articles reporting drug-induced KS.Results:Our study identified 51 patients of KS with a median age of 56 ± 14 years. Of those, 56.86% were female. The most frequently implicated drugs in KS were antimicrobials (37.25%), followed by iodinated contrast media (19.60%), NSAIDs (15.68%), and antineoplastics (9.80%). Of those, 64.70% of patients were diagnosed with KS-I, 13.72% with KS-II, and 21.56% with KS-III. Chest pain (94.1%), dyspnea (90.1%), and palpitations (60.78%) were predominant initial manifestations, and most cases (78.43%) were presented within 1st hour of drug ingestion. ST-segment changes (100%) were common ECG findings, and 64.70% of patients had elevated cardiac troponin. All patients had reduced left ventricular ejection fraction (LVEF) (

Circulation, Volume 150, Issue Suppl_1, Page A4138603-A4138603, November 12, 2024. Introduction:Kawasaki disease (KD) is a pan-vasculitis that primarily affects children and rarely adults. Available data on adult-onset KD are based on case reports and case series, both of which are limited by small sizes. We aimed to characterize the epidemiology, presentation, hospital course, and outcomes of adult-onset KD published in the English literature from 1980 through 2023.Methods:We retrospectively reviewed and included published articles with a diagnosis of KD in patients age ≥18 years. We searched PubMed and Google scholar for case reports/series published in English using the keywords “adult”, “Kawasaki disease”, and “mucocutaneous lymph node syndrome”. We extracted data from individual articles onto an Excel spreadsheet for analysis. Outcomes of interest were the demographic characteristics of patients, clinical presentation and hospital course, management, and complications. Descriptive statistics were used to analyze the data.Results:A total of 137 patients from 29 countries were included in this study. The majority were male (90/137, 64.9%; M:F ratio 1.8) and the median age was 25 years (range, 18-68). The median time to clinical presentation was 5 days (range, 4-60). The main signs and symptoms were fever (95.7%), skin rash (92.9%), conjunctivitis (89.3%), extremity changes (84.3%), oral changes (85.7%), and cervical lymphadenopathy (73.7%). The majority of the patients had no co-morbidities (125/137, 91.2%). EKG changes were not reported in 48 patients (35%). In the remaining 89, 26 (29.2%) had normal EKG or sinus tachycardia, 9 (10.1%) had ST segment elevation, and 9 (10.1%) had arrythmias or abnormal EKGs. Pharmacotherapy included IVIG (80/137, 58.4%), Aspirin (105/137, 76.6%), steroids (31/137, 22.6%) and antibiotics (68/137, 49.6%). For complications, 18.2% (25/137) had aneurysms, 8% (11/137) had myocardial infarction, 10.9% (15/137) had myocarditis, 10% had pericarditis/pericardial effusion, and 10.9% (15/137) had KD shock syndrome. The median length of stay was 14 days (range, 1-60 days). Three patients (2%) died from KD.Conclusion:Adult-onset KD is rare and is associated with significant cardiovascular complications. Clinicians should have high index of suspicion for prompt diagnoses and initiate appropriate treatment to improve outcomes.

Circulation, Volume 150, Issue Suppl_1, Page A4139384-A4139384, November 12, 2024. Background:Recent evidence suggests a therapeutic role for ketosis in patients with heart failure (HF). However, little is known regarding the safety and effectiveness of a low carbohydrate ketogenic diet (LCKD) in patients with overweight or obesity and HF.Purpose:To examine the safety and effectiveness of a LCKD in patients with overweight or obesity and HF.Methods:A retrospective review from 2006-2024 was conducted of all patients with overweight or obesity and HF who followed a LCKD with clinical oversight for at least one year in a university health system. Changes in metabolic outcomes, echocardiographic measures, and medication use were assessed. Heart failure hospitalization (HFH) rates and rate ratios (RR) and all-cause mortality rates were calculated and stratified by HF classification.Results:A total of 125 patients met inclusion criteria, including 59 patients with HF with reduced ejection fraction (HFrEF) and 66 patients with HF with preserved ejection fraction (HFpEF). Patients lost a median (interquartile range) of 11.2 kg (-19.5, 4.4;p

Circulation, Volume 150, Issue Suppl_1, Page A4144705-A4144705, November 12, 2024. Background:Giant cell arteritis (GCA) is a chronic inflammatory condition associated with a significantly increased risk of various cardiovascular and thromboembolic events. Existing studies show that there may be an increased risk of cardiovascular disease in GCA, but the results are inconsistent. This meta-analysis aims to quantify the association between GCA and the risk of various cardiovascular outcomes, providing a comprehensive evaluation of the cardiovascular burden in patients with GCA.Methods:A comprehensive literature search was carried out using several databases. Studies were included based on predefined eligibility criteria. Using random effect models, Mantel-Haenszel odds ratios and associated 95% confidence intervals were produced to report the overall effect size. Funnel plots, Egger regression tests, and Begg-Mazumdar’s rank correlation test were used to assess publication bias. The endpoint included any cardiovascular events, myocardial infarction (MI), coronary artery disease (CAD), aortic aneurysm/dissection, peripheral artery disease (PAD), stroke, and venous thromboembolism.Results:The meta-analysis included 14 studies with a combined sample size of 609,954 patients, where the mean age was 73.8 years and 72.2% were female. Patients with GCA had significantly higher odds of experiencing any cardiovascular event (OR = 1.81, 95% CI = 1.55 to 2.15), MI (OR = 1.63, 95% CI = 1.34 to 1.97), CAD (OR = 1.51, 95% CI = 1.09 to 2.08), aortic aneurysm/dissection (OR = 1.95, 95% CI = 1.55 to 2.46), PAD (OR = 2.02, 95% CI = 1.69 to 2.41), stroke (OR = 1.52, 95% CI = 1.25 to 1.84), venous thromboembolism (OR = 1.92, 95% CI = 1.73 to 2.12), deep vein thrombosis (OR = 2.09, 95% CI = 1.50 to 2.91) and pulmonary embolism (OR = 2.45, 95% CI = 1.38 to 4.36). The heterogeneity of the outcomes ranged from low to high across different analyses. No publication bias was evident in the analysis.Conclusion:The meta-analysis highlights the critical need for vigilant cardiovascular monitoring and proactive management strategies in GCA patients. Further research is needed to identify specific factors that contribute to cardiovascular complications in these patients.

Circulation, Volume 150, Issue Suppl_1, Page A4144488-A4144488, November 12, 2024. Background:Oral anticoagulants (OAC) including Vitamin K antagonists such as warfarin and direct oral anticoagulants like Apixaban, Rivaroxaban, and Edoxaban, have long been the standard treatment for stroke prevention in patients with atrial fibrillation (AF). However, they increase the risk of bleeding, making them unsuitable for certain patient populations, particularly those with a personal history of bleeding, elderly individuals prone to falls or those with high-risk occupation with safety hazards. In cases of non-valvular AF, where thrombi typically form in the left atrial appendage, mechanical left atrial appendage closure (LAAC) has come out as an alternative for selected patients. Numerous studies have shown that LAAC is comparable to OAC in preventing strokes while significantly reducing major bleeding events. This meta-analysis aims to compare the 4–5-year outcomes of these two treatment strategies in non-valvular AF.Methods:4 studies (3 randomized controlled trials and 1 observational study) comparing the 4–5-year outcomes of LAAC versus OAC in patients with AF were included in this meta-analysis. These studies were identified after a thorough search of PUBMED, COCHRANE, and MEDLINE databases from inception till May 2024. The outcomes of interest were MACE (composite of stroke, embolism, and death), ischemic stroke, major bleeding episodes, cardiovascular (CV) deaths, and all-cause death. The results were reported as Risk Ratio (RR) with 95% confidence intervals (CI), using a random effects model.Results:6,012 patients were identified from the 4 studies. After a median follow-up of 4–5 years, LAAC was associated with a clinically significant reduction in MACE (RR: 0.76, 95% CI: 0.61-0.94, p=0.01), all-cause mortality (RR: 0.77, 95% CI: 0.62-0.96, p=0.02), and CV mortality (RR: 0.64, 95% CI: 0.45-0.90, p=0.01). Additionally, a significant reduction in major bleeding episodes (RR: 0.63, 95% CI: 0.44-0.91, p=0.01) was also noted between the two treatment strategies favoring LAAC treatment group. There was no significant difference in the incidence of ischemic stroke (RR: 1.07, 95% CI: 0.62-1.85, p=0.80) between the two groups.Conclusion:Over a median follow-up of 4-5 years, LAAC was found to be as effective as OAC in preventing ischemic strokes, while also showing lower incidence of MACE, all-cause, CV mortality and major bleeding episodes. More RCTs are needed to further assess the long-term outcomes between the two strategies.

Circulation, Volume 150, Issue Suppl_1, Page A4140224-A4140224, November 12, 2024. Background:In recent years, there has been a rise in the adoption of conservative approaches to managing patent ductus arteriosus (PDA) in preterm infants. Systematic appraisal of the clinical evidence supporting this approach is essential for guiding recommendations in clinical guidelines.Methods:A comprehensive search of MEDLINE (PubMed), Embase, the Cochrane Library, and ClinicalTrials.gov, spanning from inception to April 2024, was conducted to identify all relevant randomized controlled trials (RCTs) that evaluated conservative management of patent ductus arteriosus (PDA) in preterm infants. Conservative management was defined as approximately ≤25% open-label pharmacological treatment with ibuprofen, indomethacin, or paracetamol and/or ligation/endovascular closure. Our primary outcomes were the risk of all-cause mortality and bronchopulmonary dysplasia. We used RevMan 5.4 to pool risk ratios (RRs) under a random-effects model, ensuring a rigorous and reliable analysis.Results:Our review included 6 RCTs. There was no difference in the risk of mortality (RR 0.83; 95% CI: 0.64-1.08, I2= 0%) and BPD (RR 0.89; 95% CI: 0.76-1.03, I2= 22%) between the conservative management and active treatment groups. The rates of necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, sepsis, pulmonary hemorrhage, and the need for surgical ligation or transcatheter occlusion were similar between the two groups.Conclusions:The meta-analysis showed no difference in the risk of all-cause mortality, BPD, or other clinical outcomes between a strategy of conservative management compared to active treatment. These findings support a conservative approach for the management of PDA in preterm infants. Future studies should focus on cost-effectiveness analyses between the two approaches and investigate important subgroups, such as extremely preterm births.

Circulation, Volume 150, Issue Suppl_1, Page A4125679-A4125679, November 12, 2024. Introduction:Gender minority (GM; e.g., transgender, non-binary) adults have a higher prevalence of cardiovascular disease (CVD) than their cisgender (i.e., non-transgender) counterparts. Physical activity (PA) is associated with a lower risk of CVD and all-cause mortality. Compared to cisgender adults, GM adults face unique challenges (e.g., discrimination, lack of safe spaces) to meeting aerobic and muscle-strengthening PA recommendations, which may negatively impact their overall health and well-being. There is also limited evidence on factors associated with lower PA among GM adults.Goal:To understand differences in the prevalence of PA between GM and cisgender adults and to identify factors associated with PA among GM adults.Methods:Following the PRISMA guidelines, we performed a comprehensive search using five databases (PubMed, Embase, Web of Since, CINAHL, and Scopus). We included peer-reviewed, English-language, quantitative empirical studies focused on PA among GM adults published between 2004 and 2024. We excluded qualitative studies, reviews, editorials, conference abstracts, and grey literature. We performed quality appraisal using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies.Results:A total of 5,163 articles were retrieved and 24 met inclusion criteria. The included studies had a low to moderate risk of bias. Methodological weaknesses of the included studies were an overreliance on self-reported PA with no objective assessment using accelerometry, use of non-validated PA measures, and limited assessment of muscle-strengthening PA. Most studies (n = 15) reported lower aerobic and muscle-strengthening PA among GM adults compared to their cisgender counterparts. Two studies found that GM adults with higher perceived psychological stress reported lower PA. One study found that GM adults who were on gender-affirming hormone therapy reported higher PA than GM adults who were not.Conclusions:Findings highlight that GM adults report lower aerobic and muscle-strengthening PA than cisgender adults. There is a need for more comprehensive research to understand these disparities and their impact on GM adults’ cardiovascular health. This systematic review can inform future research and the development of tailored interventions to increase PA among GM adults.