Risultati per: Il dolore neuropatico: review

Circulation, Volume 150, Issue Suppl_1, Page A4146606-A4146606, November 12, 2024. Background:Intracoronary measurement of fractional flow reserve (FFR) has demonstrated higher sensitivity and better negative predicative value in evaluation of coronary artery disease than visual/angiographic only evaluation. Nonetheless, there is profound lack of evidence in the available literature that discusses the rate of complications when utilizing FFR versus standard angiography.Research Question:Does FFR carry higher or lower risk of procedural complications when compared with standard angiography?Aim:Compare the risk of complications encountered in FFR guidance in comparison to angiography only.Methods:The following databases were searched; PubMed, SCOPUS, CENTRAL, Web of Science. The following keywords were used; ((Fractional flow reserve OR FFR) AND (Adverse effect OR Complication)). The studies were included if they compared Angiography-guided Percutaneous Coronary Intervention (PCI) and Fractional Flow Reserve (FFR)-guided PCI in terms of mortality or Major Adverse Cardiac Events (MACE). Case reports and series, animal studies, reviews and non-English articles were excluded from this study. The exposure of interest was FFR-guided PCI whereas the outcomes of interest were MACE and mortality.Results:A total of 1,822 articles were identified. After removing duplicates, initial screening, and secondary screening, 15 articles were included and the total number of included patients was 421,291. The percentage of patients who underwent FFR guidance was 3.5% whereas the rest underwent angiography only. Male predominance was noted in both, FFR and angiography. The mean age of the patients who underwent FFR and angiography was 64.9 ± 9.1 and 65.2 ± 9.3 years, respectively. The model that compared between angiography only and FFR in MACE (14 studies) showed that FFR was significantly associated with lower risk of MACE compared to angiography (RR=0.62, 95%CI:0.48-0.81); this model also showed significant heterogeneity (P-value

Circulation, Volume 150, Issue Suppl_1, Page A4138167-A4138167, November 12, 2024. Background:Intracerebral hemorrhage (ICH) has high morbidity and mortality. Traditional craniotomy causes significant trauma and lacks proven benefits. Minimally invasive techniques (MIT) like CT-guided thrombolysis, endoscopic, and neuronavigation surgeries show promise in reducing secondary neurotoxicity. Our meta-analysis compares MIT with standard treatments for supratentorial spontaneous intracerebral hematomas (SSICHs) to evaluate their effectiveness in improving clinical outcomes.Methods:We comprehensively searched PubMed, EMBASE, and Cochrane Library for studies published before June 1, 2024, comparing MIT versus standard treatment for ICH. Data were analyzed using R (v.4.3). Pooled proportions with 95% confidence intervals (CIs) were calculated using a random effects model. Odds ratios (ORs) and mean differences (MDs) with 95% CIs were used for dichotomous and continuous variables. Outcomes included overall survival, functional neurological outcome, hospitalization length, recurrent bleeding, volume reduction, and Glasgow Coma Scale (GCS) score at discharge.Results:We identified six studies, including 1,117 patients. There were 463 patients who underwent MIT and 654 patients who received standard treatment. The MIT group exhibited statistically significant increased odds of survival (OR: 1.98 [1.25, 3.15]; I2=26%; p=0.004) and functional neurological outcome (OR: 1.94 [1.27, 2.96]; I2=25%; p=0.002) compared to the standard treatment group. The MIT group demonstrated statistically significant lower length of hospitalization (MD: -2.89 [-4.49, -1.30]; I2=47%; p=0.0004) and better GCS score at discharge (MD: 1.50 [1.00, 2.00]; I2=0%; p

Circulation, Volume 150, Issue Suppl_1, Page A4145690-A4145690, November 12, 2024. Background:Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated cardiovascular benefits beyond glycemic control, including potential anti-arrhythmic effects. The impact of SGLT2 inhibitors on atrial fibrillation (AF) recurrence following catheter ablation in diabetic patients is an area of emerging interest. The purpose of this meta-analysis was to evaluate the impact of SGLT2 inhibitors on AF recurrence following catheter ablation in patients with diabetes.Methods:A comprehensive literature search was carried out using PubMed, Embase, and Google Scholar databases for the studies comparing SGLT2 inhibitors with other antidiabetic drugs in AF patients undergoing catheter ablation. Using random effect models, Mantel-Haenszel odds ratios and associated 95% confidence intervals were produced to report the overall effect size. Statistical significance was set at p < 0.05. Egger's regression test and Begg-Mazumdar's rank test were used to assess publication bias. The primary endpoint was the reoccurrence of atrial fibrillation after catheter ablation during the follow-up period, which varied between studies and ranged from 12 to 33 months.Results:The analysis included six studies, involving a sample size of around 5,765 AF patients. Our study reported that the use of SGLT2 inhibitors in diabetic patients undergoing catheter ablation for AF was associated with lower odds of AF reoccurrence (OR: 0.46; 95% CI: 0.32 to 0.65; p 0.05).Conclusion:The use of SGLT2 inhibitors was associated with improved outcomes post-catheter ablation for AF diabetic patients. Further large-scale, randomized controlled trials are warranted to confirm these findings and elucidate the underlying mechanisms.

Circulation, Volume 150, Issue Suppl_1, Page A4144910-A4144910, November 12, 2024. Introduction:Traditional ST-elevation criteria do not exhibit high sensitivity for acute occlusion detection, with many total occlusions presenting as NSTEMI, often resulting in worse outcomes. AI-based EKG interpretation may improve the identification of occlusion myocardial infarction (OMI). This study evaluates a novel AI-EKG device’s accuracy and clinical outcomes for detecting OMI in suspected ACS patients.Methods:Adult patients who underwent coronary angiogram (CAG) at Mount Sinai Morningside Hospital for unstable angina, NSTEMI, or STEMI between January 1 and December 31, 2022, were included. The AI model (PMCardio) analyzed all pre-CAG ECGs. Inclusion criteria: suspected ACS at the emergency department, no outside hospital transfers, and available peak troponin levels. OMI was defined as a culprit vessel with TIMI 0-2 flow or TIMI 3 flow and peak cTnI > 10.0 ng/mL. Primary outcome: AI EKG model’s sensitivity and specificity for predicting OMI on CAG. Secondary outcomes: F1 score, predictive values, AI OMI prediction of inpatient mortality, reduced ejection fraction at 1 year, unplanned readmissions, and STEMI criteria performance.Results:Of 257 patients, 222 met the inclusion criteria: 72 STEMI (32%), 145 NSTEMI (65%), and 5 unstable angina (3%). Confirmed angiographic OMI: 60 (83%) STEMI and 51 (35%) NSTEMI patients. AI model sensitivity was 81.08%, specificity 87.39%, AUROC 0.8423, F1 score 0.8372, PPV 86.54%, NPV 82.20%. Odds ratio of 12.44 (1.56 – 98.98) for AI-detected OMI patients, unplanned readmissions (OR 1.15 [0.53 – 2.51]), and reduced ejection fraction at 1 year (OR 0.24 [0.26 -2 .16]). Traditional STEMI criteria sensitivity for OMI was 54.05%, and specificity 89.29%. The AI model was 100% sensitive for STEMI-OMI and correctly reclassified 8 out of 12 false positive STEMI patients as NOMI.Conclusion:The AI model nearly doubles the sensitivity of traditional STEMI criteria for OMI, enabling more accurate and earlier detection. Further studies are needed to determine if earlier OMI detection with AI improves clinical outcomes. The AI’s high specificity in detecting STEMI-OMI may also reduce false positive catheterization lab activations while ensuring no true positive STEMI OMI cases are missed.

Circulation, Volume 150, Issue Suppl_1, Page A4140674-A4140674, November 12, 2024. Background:Left atrial appendage occlusion (LAAO) and catheter ablation (CA) for atrial fibrillation (AF) have been increasingly performed in combination. However, the effects of this combined procedure remain unknown.Hypothesis:Combined LAAO and CA improves outcomes of patients with AF relative to isolated LAAO.Aims:To compare the outcomes of combined LAAO and CA with isolated LAAO in patients with AF.Methods:PubMed, Embase, and Cochrane Library were systematically searched from inception to March 2024 to identify studies comparing combined LAAO and CA versus isolated LAAO. We pooled odds ratios (OR) with 95% confidence intervals (CI) for binary endpoints. Statistical analyses were performed using R software version 4.3.1.Results:We included eight retrospective studies comprising 51,802 patients, of whom 1,375 (2.6%) received the combined procedure, and 29,696 (57.3%) were men. Mean age of patients ranged from 63.6 to 71.4 years. Follow-up ranged from 1 to 37.6 months. Additionally, 626 (1.2%) patients had paroxysmal AF and 757 (1.4%) had persistent AF. There were no significant differences between the combined procedure and LAAO alone in terms of major bleeding (OR 0.55; 95% CI 0.09 to 3.41; p=0.52; Figure 1A), stroke (OR 1.03; 95% CI 0.35 to 3.00; p=0.96; Figure 1B), or pericardial effusion (OR 1.18; 95% CI 0.60 to 2.33; p=0.63; Figure 1C).Conclusion:In this meta-analysis, there were no significant differences in major bleeding, stroke, or pericardial effusion when comparing combined LAAO and CA with isolated LAAO.

Circulation, Volume 150, Issue Suppl_1, Page A4137175-A4137175, November 12, 2024. Background:Recent studies showed that functional mitral valve regurgitation (FMR) was associated with higher long-term mortality in chronic heart failure patients and poorer outcomes in those with atrial fibrillation (AF), including a higher risk of atrial cardiomyopathy. However, the effect of baseline FMR on outcomes post-AF catheter ablation remains unclear due to inconsistent evidence.Methods:We systematically reviewed studies from Medline and EMBASE databases from inception to April 2024. Eligible studies must report the association between baseline FMR and risk of AF recurrence post-AF catheter ablation compared to individuals without FMR. Relative Risk (RR) or hazard ratio (HR) and 95% CIs were retrieved from each study and combined using the generic inverse variance method.Results:Our meta-analysis included 7 cohort studies and found that baseline FMR was associated with a higher risk of AF recurrence compared to those without FMR. The pooled risk ratios (RR) were 1.40 (95% CI 1.11-1.78, I2 = 31%, p = 0.005). No publication bias was identified on the funnel plot.Conclusions:Our pooled analysis found that patients with FMR who underwent AF catheter ablation had a higher risk of AF recurrence compared to those without FMR. Further research is needed to explore the underlying mechanisms and their clinical implications.Keyword:Functional mitral regurgitation, Atrial fibrillation, Catheter ablation, Atrial fibrillation recurrence, Systematic review, Meta-analysis

Circulation, Volume 150, Issue Suppl_1, Page A4146666-A4146666, November 12, 2024. Introduction:Transcatheter aortic valve implantation (TAVI) is widely regarded as the treatment modality of choice for the effective and safe treatment of native aortic stenosis among patients with high surgical risk. However, bundle branch block (BBB) following TAVI is well-documented and widely regarded to be the leading complication associated with TAVI, along with other conduction abnormalities such as atrioventricular node block (AVB).Research Question:is the risk of BBB higher with a particular type of TAVI valve compared to the rest?Aim:To evaluate the risk of developing BBB following TAVI across the different valve types in a systematic and meta-analytic approach.Methods:The following databases were searched; PubMed, Scopus, Cochrane Library, and ClinicalTrials.gov. We used the following keywords in the search; ((Transcatheter aortic valve implantation OR Transcatheter aortic valve replacement OR TAVI) AND (Bundle branch block OR Right bundle branch block OR Left bundle branch block OR BBB)). The studies were included if they reported the prevalence of BBB in patients undergoing TAVI with a specified type of valve such as balloon-expandable valve (BEV), self-expandable valve (SEV), and mechanical-expandable valve (MEV).Results:A total of 827 articles were initially identified and eventually only 176 studies were thoroughly reviewed. Finally, 105 articles (55 BEV, 44 SEV and 6 MEV) were included in this systematic review and meta-analysis with a total number of included patients being 65,491. The prevalence of patients who underwent BEV and developed a bundle branch block were 30% (95%CI 0.29-0.31). Moreover, the prevalence of bundle branch block in patients who had a SEV implant were 16% (95% CI 0.16-0.16), whereas patients who underwent a MEV implant had an exceptionally high prevalence of bundle branch block of 54% (95%CI 0.52-0.56). The overall prevalence of BBB in patients undergoing a TAVI was 31% (95% CI 0.17-0.50) using random effects model. Utilization of this model also demonstrated significant heterogeneity (P-value

Circulation, Volume 150, Issue Suppl_1, Page A4147960-A4147960, November 12, 2024. Introduction:Blood pressure targets for the elderly are still controversial, there is a lack of certainty about the benefit and safety of targeting ≤ 130mmHg systolic blood pressure. Evaluate the benefit in important cardiovascular outcomes and safety in elderly patients of a blood pressure control ≤ 130mmHg compared to standard of care.Methods:The research was performed in PubMed, EMBASE, Scielo, LILACS, and Cochrane Central Register of Controlled Trials (CENTRAL) from January 1st, 2013 to May 1st, 2023. Randomized controlled trials that were published between January 1st, 2013 and May 1st, 2023 that included hypertensive patients over 60 years old which reported major adverse cardiovascular outcomes (MACE) or all-cause mortality, cardiovascular mortality and safety outcomes were selected. The data extraction was performed independently by two investigators following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). A meta-analysis was performed using a fixed-effect model. The results were reported as the pooled results using risk ratio (RR) and a confidence interval (CI) of 95%.Results:The 4 trials included a number of 16,834 patients, the mean age was over 65 years, there was a good balance between genders, 13.3% of patients had cardiovascular disease, 10.9% diabetes, and 15.5% chronic kidney disease. The mean achieved blood pressure was roughly under 130mmHg, only one study was over (135mmHg) and the mean follow-up time was over 32 months. The intensive therapy decreased the outcomes for mortality (RR = 0.75, 95% CI 0.64 – 0.87, p

Circulation, Volume 150, Issue Suppl_1, Page A4144031-A4144031, November 12, 2024. Introduction:Catheter ablation (CA) therapy is well established therapy for different types of atrial fibrillation, with some concern including post ablation pericarditis which increases the morbidity and mortality. Colchicine, known for its anti-inflammatory effects has shown to be effective in reducing the incidence of perioperative AF after cardiac surgery. However, the efficacy of post ablation colchicine is still debatable. We aimed to establish evidence on the use of colchicine for preventing pericarditis after catheter ablation.Methods:We searched PubMed, Scopus, WOS and Cochrane until May 2024 for relevant studies that assessed colchicine after CA. The primary outcome of interest was the incidence of pericarditis following AF. Other secondary outcomes were the incidence of pericardial effusion, GI adverse events, and hospitalization rates.Results:A total of nine studies were included with a total of 2795 patients aged 66 to 69.4 years, Colchicine administration before catheter ablation showed a significant decrease in the occurrence of clinical pericarditis after AF ablation compared to placebo (RR=0.38; 95% CI: 0.27, 0.53). Moreover, colchicine was favored to decrease the incidence of AF recurrence rate at 3, 6, and 12 months with the following values, respectively (RR=0.58, 95% CI: 0.42 to 0.80, 0.69, 95% CI: 0.5 to 0.97, and 0.76, 95% CI: 0.66 to 0.87). On the other hand, colchicine was associated with a significant increase in GI adverse events (RR= 2.62, 95% CI: 1.57, 4.37).Conclusion:Colchicine was found to be a promising intervention for reducing the incidence of pericarditis following atrial fibrillation ablation. Despite some contradictory data about gastrointestinal side effects, cautious dosage measures, such as weight-adjusted doses, may improve tolerability while maintaining efficacy in reducing post-ablation events.

Circulation, Volume 150, Issue Suppl_1, Page A4139706-A4139706, November 12, 2024. Background and Aim:For metastatic castrate-resistant prostate cancer (mCRPC), the European Association of Urology recommends multiple therapies as first-line. However, these recommendations do not account for additional cardiotoxicity of the therapies for prior stages of the disease, such as the metastatic hormone-sensitive prostate cancer (mHSPC) stage. We seek to adjudicate the cardiotoxicities of first-line mCRPC therapies assuming history of mHSPC treatment based on the five International Cardio-Oncology Society (IC-OS) cardiotoxicity domains: heart failure, myocarditis, vascular toxicity, hypertension, and arrhythmias.Methods:Ovid Medline, Elsevier Embase, and the Cochrane Library were searched for randomized clinical trials (RCTs) of mCRPC and mHSPC patients from inception until January 2024. Studies reporting at least one first-line therapy and effect size of at least one cardiotoxicity domain were included. Network meta-analyses with indirect treatment comparison with multivariate multi-level analysis were performed for each cardiotoxicity domain to estimate relative risk (RR) with 95% confidence intervals (CI) for mCRPC and mHSPC therapies. A Bayesian model was then constructed using the mHSPC network as a prior for informing the RRs and 95% CIs of mCRPC first-line therapies.Results:Network meta-analyses of mHSPC treatment cardiotoxicity, mCRPC treatment cardiotoxicity assuming no treatment history, and mCRPC treatment cardiotoxicity assuming prior mHSPC treatment are provided in Images 1-2. We did not find any studies assessing myocarditis. For patients with mHSPC treatment history, olaparib (OLA) plus androgen deprivation therapy (ADT) plus abiraterone with prednisone (AA+P) decreased hypertensive risk relative to ADT+AA+P (RR 0.20, 95% CI 0.16-0.26).Conclusion:OLA may offer a protective antihypertensive effect when superimposed on ADT+AA+P for mCRPC treatment after prior androgen deprivation from mHSPC therapy.

Circulation, Volume 150, Issue Suppl_1, Page A4121530-A4121530, November 12, 2024. Background:Percutaneous coronary intervention (PCI) is the preferred revascularization strategy for acute myocardial infarction (AMI). Drug-eluting stents (DES) are linked to higher risks of stent restenosis and stent thrombosis when implanted for AMI. Drug-coated balloons (DCB) provide a high concentration of anti-proliferative drugs over the target lesion without using the polymeric stent structures. The current literature comparing DCB to DES for AMI PCI is limited.Methods:A systematic literature search was performed on the major electronic databases for studies comparing DCB to DES for AMI PCI. Mean difference (MD) and odds ratio (OR) with their corresponding 95% confidence intervals were pooled using a random-effects model, and a p-value of

Circulation, Volume 150, Issue Suppl_1, Page A4141922-A4141922, November 12, 2024. Advances in modeling methodology and increased democratization of software led to rapid increase in novel prediction models. In clinical research, these models proclaim novel predictors, promise superior accuracy and meaningful improvements in patient outcomes. Developing an accurate prediction model requires rigorous methodology with great attention to study design and conduct. Failure to adhere leads to prediction bias and may result in harmful decisions.We conducted a systematic review of research articles in heart failure listed in PubMed 2018 – 2023 and presented by their authors as developing prediction models, either diagnostic or prognostic. The study variables were selected based on PROBAST and TRIPOD (Table 1). These were summarized and the study conducts were evaluated against the gold standard of prediction modeling per PROBAST and TRIPOD. For each study, we calculated the optimal sample size, i.e. the minimal size required for at least 5% prediction accuracy and 90% shrinkage in parameters. Sentiment analysis was performed to estimate the prevalence of promotional language in the abstract corpus.From 6,429 studies, 212 studies were presented as developing prediction models. Of those, 83 (39%) were truly about developing prediction models (TPM) and the rest were impostors, i.e. inferential models misrepresented as predictive.Mostly, TPMs were prognostic, modeled binary outcomes, and employed machine-learning methods (Table 1). Commonly, essential data volume summaries were lacking and handling of missing data was inadequate. The deficit in the number of samples in model training was 1499 (-316, 3866) samples with 52(71%) studies below the optimal size.Model validation or testing was not performed in 30% of the studies. Discrimination statistics were reported often in testing but not in validation. The calibration was rarely assessed at either phase. Thirty (36%) studies had enough information to implement risk score calculations. The sentiment analysis showed increased use of hype words in both TPMs and impostors relative to 2020-rates in Millar et al (2022).Most TPM studies exhibit poor design, insufficient sample size, mishandling of missing data, and inadequate model evaluation. These deficiencies result in biased risk estimates, degrade the performance in external data limiting generalizability and clinical utility of the developed models. Excessive use of hype can be misleading and may impede objective evaluation by the readers.

Circulation, Volume 150, Issue Suppl_1, Page A4135975-A4135975, November 12, 2024. Introduction:Coronary artery ectasia (CAE) is a rare but well-recognized anatomical abnormality of the coronary arteries with a prevalence of up to 9% in patients presenting with acute coronary syndrome (ACS). While anticoagulants have been suggested to reduce recurrent events, the optimal antithrombotic therapy in CAE and ACS remains unclear.Research Question:What is the comparative effect of anticoagulation therapy versus no anticoagulation in patients with CAE and ACS receiving background antiplatelet therapy?Goals:To perform a systematic review and meta-analysis evaluating the efficacy of anticoagulation in preventing major adverse cardiovascular events (MACE) among patients with CAE and ACS.Methods:We searched PubMed, Embase, and Cochrane to identify studies comparing the use of anticoagulants versus no use of anticoagulants as part of the antithrombotic therapy in patients presenting CAE and ACS, and reported MACE. Statistical analysis was performed using R version 4.2.2 adopting the Mantel-Haenszel random-effects model. Heterogeneity was assessed using Cochrane’s Q statistic and Higgins and Thompson’s I2 statistics. Pooled risk ratios were used to evaluate the effectiveness of anticoagulant therapy in CAE and ACS.Results:We included 3 studies, including 1 randomized controlled trial and 2 observational studies, comprising a total of 441 patients, of whom 162 (36.7%) received anticoagulants, including vitamin K antagonists (warfarin and acenocoumarol) or direct oral anticoagulants (rivaroxaban, apixaban, and dabigatran). Time of follow-up ranged from 12 to 52 months, mean age was 57.9 ± 11.4 years, and 388 (87.9%) were male. We found no significant difference in MACE between patients who received anticoagulation and patients who did not (RR 0.64; 95% CI 0.31, 1.32; p=0.22; I2 = 0%). Additionally, there was no difference in the risk of re-infarction (RR 0.71; 95% CI 0.43, 1.18; p=0.19; I2 = 0%). Finally, there was no significant difference in risk of bleeding between both groups (RR 1.41; 95% CI 0.70, 1.85; p=0.19; I2 = 0.59%).Conclusion:Our findings suggest that, among patients with CAE and ACS, anticoagulation does not reduce the risk of MACE or re-infarction as compared with no anticoagulation.

Circulation, Volume 150, Issue Suppl_1, Page A4139617-A4139617, November 12, 2024. Background:As the burden of cardiovascular diseases (CVD) in sub-Saharan Africa (SSA) rises, context-specific evidence on how to successfully scale proven CVD prevention and control interventions is urgently needed.Objective:To assess the current state of implementation science on priority CVD prevention and control interventions provided within health systems in low- and middle-income countries (LMICs).Methods:EMBASE and MEDLINE databases were searched from 1990 through 2021 to identify implementation science studies on the World Health Organization priority CVD control interventions provided within health systems in LMICs. Any empirical and peer-reviewed studies that focused on these interventions and reported implementation outcomes were eligible for inclusion. Extracted data were synthesized narratively using descriptive statistics. Subgroup analysis was performed to describe the available context-specific evidence in SSA.Results:Of the unique records screened for inclusion, 103 eligible studies evaluated 145 priority CVD prevention and control interventions implemented in 38 countries. Of these studies, only 8% were conducted in SSA and focused on 15 interventions. Prevention interventions accounted for 18% overall and 8% in SSA, screening for 12% overall and 23% in SSA, and treatment for 70% overall and 69% in SSA. The implementation strategies were not specified well enough. Feasibility was the most studied implementation outcome whereas sustainability was the least studied. Most studies used quantitative methods and weak study designs. Most studies reported funding (77%), with international funding being the predominant source. Most studies were pilot (86% overall vs 92% in SSA) and targeted the micro level of health system (73% vs 92% in SSA).Conclusions:Implementation research on CVD in LMICs has risen steadily over the last few decades; however, major gaps in the science persists especially in SSA. Future studies should prioritize implementation at scale, target higher levels health systems and test sustainability of CVD programs. They should employ designs with stronger internal validity, be more conceptually driven, and use mixed methods to understand mechanisms. To maximize impact of the research under limited resources, adding implementation science outcomes to effectiveness research and regional collaborations are promising.

Circulation, Volume 150, Issue Suppl_1, Page A4136600-A4136600, November 12, 2024. Background:Hypertensive disorders of pregnancy (HDP) are associated with maternal adverse cardiovascular outcomes. However, their association with maternal Dementia and Alzheimer’s disease is not well established with limited and conflicting results to date.Objective:We sought to evaluate the association between HDP and risk of incidence of Dementia, and Alzheimer’s disease.Methods:We performed a systematic review and meta-analysis of available literature that enrolled women with HDP and women without HDP groups. PubMed, Embase and ClinicalTrials.gov were systematically searched from inspection till May 2024 without any language restrictions. Adjusted hazard ratios (aHR) and 95% confidence intervals (CI) were pooled using a random-effect model.Results:A total of 8 studies with 2503538 patients (1,51,905 in women with HDP and 23,51,633 in the women without HDP group) were included. Pooled analysis shows that HDP women were having 37% higher risk of dementia (aHR, 1.37(95%CI: 1.27-1.46), P

Circulation, Volume 150, Issue Suppl_1, Page A4120966-A4120966, November 12, 2024. Background The development of in-stent restenosis (ISR) has emerged as a substantial barrier to interventional treatment for coronary heart disease. Drug-coated balloon (DCB) is an efficacious interventional technique for the management of ISR. This meta-analysis compares the efficacy of DCB in the treatment of ISR with that of an uncoated balloon (UCB). Methods We comprehensively searched literature on MEDLINE, Embase, Cochrane, and clinicaltrials.gov using MeSH terms and relevant keywords for “Balloon Angioplasty” and “in-stent Restenosis” from inception to June 1, 2024, followed by a meta-analysis of all randomized controlled trials (RCTs) to assess both strategies for treatment of ISR. Random effects model was used to aggregate the risk ratios (RR) for dichotomous and mean differences (MD) for continuous outcomes, with 95% confidence intervals (CI). Results The search strategy retrieved 2330 studies. Duplicates and irrelevant articles were removed and data from seven RCTs (1,408 patients) was extracted. The mean age ranged from 64 to 74 years. The mean clinical follow-up ranged from 1 to 10 years. DCB was found to be superior to UCB at latest follow up in terms of target lesion revascularization (TLR) (RR 0.34, 95% CI 0.19-0.58; p 0.0001; I2 79%), major adverse cardiovascular events (MACE) (RR 0.41, 95% CI 0.23-0.73; p 0.003; I2 84%), late lumen loss (LLL) (MD -0.46 mm, 95% CI -0.64- -0.28]; p