Risultati per: Colite ulcerosa negli adulti: review

Circulation, Volume 146, Issue Suppl_1, Page A15820-A15820, November 8, 2022. Background:There continues to be emerging data about the benefits of Sodium-glucose co-transporter 2 inhibitor (SGLT2i) in patients with heart failure. This has led to the addition of this medication to guideline-directed medical therapy for heart failure with reduced ejection fraction. There is a discrepancy in whether the use of SGLT2i is beneficial in patients hospitalized for decompensated heart failure.Methods:In this study, a search was completed through PubMed, Scopus, Cochrane Library, ProQuest for randomized controlled trials from 2020 to 2022 that evaluated the impact of the use of SGLT-2 inhibitors (Empagliflozin, Sotagliflozin) in patients admitted with acute HF. After screening for our preset inclusion and exclusion criteria, three randomized controlled clinical trials were eligible for inclusion. We carried out a Meta-analysis of the relative odds on the basis of the random effect model using the Mantel-Haenszel method for the major outcome of the incidence of death from any cause, the number of heart failure events, rehospitalization for heart failure, and time to first heart failure event in the acute setting. Comprehensive Meta-analysis version 3 software was used for analysis.Results:A total of 2,532 patients from the EMPULSE, SOLOIST-WHF, EMPA-RESPONSE-AHF trials were included. After analysis, it was found that the P-value was 0.000, Z-value was -4.103, and the OR 0.508 (95% CI 0.368; 0.702) for the patients on either Empagliflozin or Sotagliflozin.Conclusions:The systematic review and meta-analysis we conducted show that patients who received SGLT-2i (Empagliflozin, Sotagliflozin) during hospitalization within 24 hours or more had a statistically significant decreased odds of all-cause of death, number of heart failure events, and rehospitalization for heart failure.

Circulation, Volume 146, Issue Suppl_1, Page A15248-A15248, November 8, 2022. Hypothesis:Transcatheter aortic valve replacement (TAVR) serves as a less-invasive treatment option for high-risk patients with severe aortic stenosis. Given the coexistence of obstructive coronary artery disease in patients with high-grade aortic stenosis (estimated to be 40-75%), there is inconsistent clinical data regarding potential mortality benefits of paired percutaneous coronary intervention (PCI) with TAVR procedures.Methods:We performed a literature search using PubMed, Embase, and Cochrane Library from inception through April 2022 to assess the mortality impact of preceding/concomitant PCI in patients undergoing transcatheter aortic valve replacement. The primary outcomes were 30-day all-cause mortality, 30-day cardiovascular mortality, and 6 months-1 year all-cause mortality. Secondary outcomes included 30-day myocardial infarction, stroke, major bleeding/vascular complications, and acute kidney injury.Results:11 studies (10 retrospective cohort studies, 1 randomized control trial) involving 2791 patients were included in the meta-analysis. Compared to patients undergoing TAVR alone, the TAVR+PCI group showed no significant difference in 30-day all-cause mortality (RR 0.90, CI 0.66, 1.22, p =0.49), 30-day cardiovascular mortality (RR 0.71 CI 0.44, 1.14, p =0.16), or 6 months-1 year all-cause mortality (RR 0.94, CI 0.75, 1.18, p =0.57). Regarding secondary outcomes, 30-day myocardial infarction was higher in the TAVR+PCI group compared to the TAVR group (RR 3.09, CI 1.26, 7.57, p =0.01), while no significant differences were found in rates of 30-day stroke (RR 1.14, CI 0.56, 2.33, p =0.72), major bleeding/vascular complications (RR 1.11, CI 0.79, 1.56, p =0.55), and acute kidney injury (RR 1.07, CI 0.75, 1.54, p =0.71).Conclusion:Concomitant/preceding percutaneous coronary intervention does not confer any additional mortality benefit, and may increase the risk of 30-day myocardial infarction, in patients with high-grade aortic stenosis undergoing transcatheter aortic valve replacement. Further trials with large sample sizes are needed to confirm our findings.

Circulation, Volume 146, Issue Suppl_1, Page A14772-A14772, November 8, 2022. Introduction:Vascular closure devices have shown marked improvement in patient comfort and time to ambulation after undergoing atrial fibrillation (AF) and atrial flutter (AFL) radiofrequency ablation. They have been proven superior to manual closure and Figure of 8 suture in terms of pain control and time to ambulate. However, data comparing different vascular closure devices is sparse.Hypothesis:To compare the efficacy of venous closure devicesMethods:We retrospectively reviewed 100 patients at our institution who underwent AF and AFL radiofrequency ablation. We aimed to assess the difference in time to ambulation, device failure, pain control and vascular complication rate between the two commonly used venous closure devices (VASCADE and PERCLOSE).Results:A total of 100 patients (50 in each arm) were included in the study. The mean age was 67.6+9.3 years and 73% patients were men. The two groups were well balanced with respect to baseline demographics and clinical characteristics except for coronary artery disease (24%VASCADE vs. 14% PERCLOSE, p

Circulation, Volume 146, Issue Suppl_1, Page A14753-A14753, November 8, 2022. Introduction:Impact of time savings with the use of automated left ventricular volume measurements has not been systematically quantified.Hypothesis:Automated measurement of left ventricular volumes will lead to significant time savings.Methods:Electronic search of MEDLINE and EMBASE was performed. Inclusion criteria included 1) LVEF (either 2D or 3D) quantification using completely automated software, 2) comparator group of manual measurements and 3) stated mean and standard deviation of measurement time. Meta-analysis was performed with studies weighted by DerSimonian-Laird method and pooled using random-effects model.Results:6 studies of automated 3D-LVEF measurement were identified with total of 697 pts. Time savings for 3D-LVEF automation was -371.0 seconds per study (95%CI -754.6 to +12.6 seconds, p = 0.058, Q (df=5) 2104.3, I2 99.9%), which was non-significant. HeartModel (Phillips) was used in 4 studies with 550 patients with non-significant time savings of -452.3 seconds (95%CI -1029.5 to +124.9 seconds, p=0.12, Q(df=3) 1954.1, I2 99.9%). 4D AutoLVQ (GE) was used in 1 study of 103 patients with significant time savings (142±30 sec vs. 226±114 sec, p

Circulation, Volume 146, Issue Suppl_1, Page A9568-A9568, November 8, 2022. Introduction:Although the preventive effect of sodium-glucose cotransporter 2 (SGLT2) inhibitors for new-onset diabetes was investigated as secondary analyses of recent randomized controlled trials (RCTs), the synthesized evidence is lacking. We thus aimed to summarize the effects of SGLT2 inhibitors on preventing new-onset diabetes.Hypothesis:We assessed the hypothesis that SGLT2 inhibitors reduce the incidence of diabetes among patients with prediabetes and heart failure or chronic kidney disease.Methods:In this systematic review and meta-analysis of RCTs, MEDLINE and EMBASE were searched through February 11, 2022. Two independent authors screened the search results and extracted data from eligible RCTs (including both original and post hoc analyses) comparing SGLT2 inhibitors and placebo for the risk of new-onset diabetes among adults with prediabetes. No restrictions on publication date and language were applied. Meta-analysis was conducted using random-effects models to calculate risk ratios and 95% confidence intervals (CIs).Results:We included 4 RCTs with 5655 participants who had prediabetes. All studies had a low risk of bias and were conducted for treatments of heart failure or chronic kidney disease. Based on the random-effects meta-analysis, SGLT2 inhibitors were significantly associated with a lower risk of new-onset diabetes (relative risk, 0.79; 95% CI, 0.68 to 0.93, I2 =0·0%). The relative risks of new-onset diabetes in dapagliflozin and empagliflozin were 0.68 (95% CI, 0.52 to 0.89) and 0.87 (95% CI, 0.72 to 1.04), respectively (p-for-heterogeneity =0.14). The frequency of severe hypoglycemia was not elevated in the SGLT2 inhibitors group compared to the placebo group.Conclusions:In this meta-analysis, SGLT2 inhibitors were associated with a reduced risk of new-onset type 2 diabetes among adults with prediabetes and heart failure or chronic kidney disease. These findings indicate the potential usefulness of SGLT2 inhibitors as a pharmaceutical approach to prevent diabetes in conjunction with lifestyle modification among high-risk adults with prediabetes.

Circulation, Volume 146, Issue Suppl_1, Page A12936-A12936, November 8, 2022. Introduction:Aortic stenosis (AS) patients admitted for elective transcatheter aortic valve replacement (TAVR) frequently present significant coronary artery disease (CAD). Despite the increasing number of TAVR procedures, it remains unclear if the strategy of performing percutaneous coronary intervention (PCI) and TAVR during the same hospitalization differs from isolated TAVR.Methods:We performed a systematic review and meta-analysis of observational studies in patients with AS and significant CAD (lesions ≥50%). The aim of the study was to compare TAVR and PCI on same hospitalization (with no regard for whether in the same procedure) to TAVR and deferred PCI. In-hospital mortality, acute kidney injury and major bleeding were our outcomes of interest.Results:We included 4 studies with 2917 patients, 665 treated with TAVR+PCI and 2252 treated with TAVR alone. TAVR+PCI was associated with higher in-hospital mortality (OR 1.66; 95% CI 1.21 – 2.27; p=0.002; Fig. 1). However, there was no difference in acute kidney injury (OR 0.59; 95% CI 0.26 – 1.32; p=0.20; Fig. 2A). Furthermore, TAVR+PCI seemed to lower the rate of major bleeding (OR 0.65; 95% CI 0.46 – 0.93; p=0.02 Fig. 2B).Conclusions:In this meta-analysis of retrospective studies, TAVR and PCI on same hospital admission was associated with higher in-hospital mortality when compared to isolated TAVR.

Circulation, Volume 146, Issue Suppl_1, Page A12706-A12706, November 8, 2022. INTRODUCTION:Prolonged cardiac monitoring is frequently used to detect atrial fibrillation (AF) in high-risk populations, with the goal of preventing thromboembolic events. We sought to determine the impact of prolonged cardiac monitoring on the incidence of stroke and systemic embolism (SSE) or transient ischemic attack (TIA)METHODS:We performed a systematic review and meta-analysis of randomized trials evaluating prolonged monitoring versus usual care (PROSPERO #CRD42021277611). Studies were identified through CENTRAL, MEDLINE, and Embase. We included studies with ≥100 participants and ≥30 days follow-up. The primary outcome was a composite of SSE/TIA, as reported in the original trials. Secondary outcomes included AF detection, oral anticoagulation (OAC) initiation, and major bleeding. Sensitivity analysis examining the impact of monitoring device, and indication for monitoring were performed. Meta-analyses were performed with R using a random-effects model.RESULTS:From 1411 records, we included 9 RCTs (n = 10,205). Mean age was 70 years, 40% were female, and mean CHADS2 score was 4.0. Studies used implantable cardiac monitors (n = 4), external cardiac monitors (n = 3), or handheld ECG devices (n = 2). Study populations included post-stroke (n = 5), high risk for AF or stroke (n = 2), and post-cardiac surgery (n = 1). Mean follow-up was 16 months (range 3-65). Extended monitoring did not significantly reduce the primary outcome (Figure, random effects risk ratio [RR] 0.87, 95% confidence interval [CI] 0.72-1.06, I2 = 0%) or its individual components. Extended monitoring increased AF detection (RR 4.56, 95% CI 3.01-6.92, I2 = 65%) and OAC usage (RR 2.25, 95% CI 2.01-2.53, I2 = 0%), but did not impact major bleeding (RR 1.23, 95% CI 0.84-1.82, I2 = 0%).CONCLUSION:Prolonged monitoring was associated with increased AF detection and OAC use, without significantly reducing the occurrence of thromboembolic events.

Circulation, Volume 146, Issue Suppl_1, Page A11548-A11548, November 8, 2022. Background:Evidence demonstrated gender disparities after transcatheter aortic valve replacement (TAVR) with early generation transcatheter heart valves (THV)s. However, it is unclear whether gender-related differences persist with the newer generation THVs. We conducted this meta-analysis and systematic review to assess gender disparities after TAVR with newer generation THVsMethods:We searched MEDLINE, and Embase databases from inception to May 2022 to identify studies that reported gender-specific outcomes after TAVR with newer generation THVs (Sapien 3, Corevalve Evolut R, and Evolut Pro). Outcomes of interests included 30-day mortality, 1-year mortality and vascular complications. Data were pooled using random-effects models to calculate pooled odds ratio (OR) and 95% conference interval (CI).Results:Four studies with a total of 47,933 patients (21,073 in females and 26,860 in males) were included. Ninety-six percent received TAVR via transfemoral approach. Females had higher 30-day mortality (OR = 1.53, 95%CI 1.31-1.79, p-value (p) < 0.001) and vascular complications (OR=1.43, 95%CI 1.23-1.65, p< 0.001). However, 1-year mortality was similar between 2 groups (OR=0.83, 95%CI 0.67-1.04, p=0.33).Conclusions:Higher 30-day mortality after TAVR in females may be attributed from higher vascular complications. Further research is needed to explore potential causes of increased mortality. While vascular complications may be an etiology, other patient characteristics or procedure-related issues should be evaluated.

Circulation, Volume 146, Issue Suppl_1, Page A11771-A11771, November 8, 2022. Background:Obesity is usually associated with worse cardiovascular outcomes. However, fewer studies have evaluated its impact on long-term major adverse cardiovascular events (MACE) following CTO PCI. We conducted a meta-analysis to assess the same.Methods:PUBMED, Scopus, and EMBASE were systematically searched for studies reporting long-term (at least >1 year) outcomes with obesity vs no obesity in patients with CTO PCI. MACE events [all-cause mortality, cardiac mortality, revascularization, restenosis/reocclusion, recurrent angina pectoris (RAP), target-vessel myocardial infarction (MI), heart failure, cardiac death, or ischemia-driven target-vessel revascularization (TVR) were the primary endpoint. Pooled odds ratios (OR) and heterogeneity were assessed with random-effects models and I2 statistics respectively. Subgroup analysis was performed to assess the risk by age group and follow-up duration. The leave-one-study-out method was used for sensitivity analysis.Results:After an initial electronic search of thirty-two studies, five studies were selected, and between 2016 to 2021 selected were included in the final analysis. The sample size consisted of 5022 patients with a median age of 63. No significant impact of higher BMI/obesity was seen overall on a median duration of 2.6 yrs [OR(95% CI)= 0.95 (0.82-1.11), p=0.53, I2= 90.86%)](Fig 1).However, on a subgroup analysis, the geriatric age group (≥65 yrs) demonstrated an “Obesity Paradox” effect on MACE after CTO PCI, [OR (95%CI)=0.64 (0.47-0.88), I2=42.13, p

Circulation, Volume 146, Issue Suppl_1, Page A12187-A12187, November 8, 2022. Objective:This meta-analysis aimed to evaluate outcomes of transcatheter aortic valve replacement (TAVR) with percutaneous coronary intervention (PCI) versus surgical aortic valve replacement (SAVR) with coronary artery bypass grafting (CABG).Methods:MEDLINE and EMBASE were searched through November 2021 to identify studies comparing TAVR+PCI and SAVR+CABG for severe aortic stenosis with concurrent coronary artery disease. Outcomes of interest were long-term all-cause mortality, repeat coronary intervention, rehospitalization, myocardial infarction, and stroke during follow-up, and 30-day periprocedural outcomes.Results:Two randomized controlled trials and six observational studies including a total of 104,220 patients (TAVR+PCI, n = 5,004; SAVR+CABG, n = 99,226) were included. Median follow-up periods ranged from one to three years. TAVR+PCI was associated with higher all-cause mortality and coronary reintervention during follow-up period (Hazard Ratio [HR], 1.35; 95% confidence interval [CI], 1.11-1.65; p = 0.003, HR, 4.14; 95% CI, 1.74-9.86; p = 0.001, respectively), 30-day permanent pacemaker implantation rate (Odds Ratio [OR], 3.79; 95% CI, 1.61-8.95; p = 0.002), and periprocedural vascular complications (OR 6.97; 95% CI, 1.85-26.30; p = 0.004). In contrast, TAVR+PCI was associated with a lower rate of 30-day acute kidney injury (OR, 0.32; 95% CI, 0.20-0.50; p = 0.0001). Rehospitalization, myocardial infarction, stroke during follow-up, and other periprocedural outcomes including 30-day mortality were similar in both groups.Conclusions:In patients with severe aortic stenosis and coronary artery disease, TAVR+PCI was associated with higher all-cause mortality at follow-up compared with SAVR+CABG. Heart team approach to assess TAVR candidacy remains imperative.

Circulation, Volume 146, Issue Suppl_1, Page A15112-A15112, November 8, 2022. Introduction:Subcutaneous implantable cardioverter-defibrillator (S-ICD) is an alternative to transvenous implantable cardioverter-defibrillator (T-ICD) in select patients with complex anatomy, high infection risk and venous access issues. T-ICD is known to cause perioperative and long-term complications. Considering expanding indications for S-ICD, ongoing uncertainty in efficacy and unknown utility in low-risk patients, we performed this updated meta-analysis to study device related complications in both the systems.Methods:We performed a meta-analysis using electronic literature search to retrieve studies that compared S-ICD to T-ICD. Outcomes of interest were efficacy and device-related complications. Outcomes were pooled under random-effects and reported as risk ratios (RRs) and 95% CIs. 15 studies (observational, case-control and RCTs), median follow up 31.1 months, with variable heterogeneity for different outcomes (Fig-1), were included to capture real-world data.Results:A total of 21628 patients (S-ICD group n=3594, male 72.6%, mean age 50.1±10y and T-ICD group n=18034, male =72.6%, mean age 53.3±10.6y) were recruited. Lead-related complications were significantly lower in S-ICD, RR {0.21 [0.13, 0.34], P=

Circulation, Volume 146, Issue Suppl_1, Page A12960-A12960, November 8, 2022. Background:Iron deficiency in patients with systolic heart failure (HF) was found to be associated with poorer exercise capacity and quality of life. We conducted this systematic review and meta-analysis to assess whether iron supplementation in patients with systolic HF can improve exercise capacity and quality of life.Methods:We searched MEDLINE, and Embase databases from inception to May 2022 to identify the studies that reported the impact of iron therapy including oral and intravenous (IV) iron forms in systolic HF patients with iron deficiency. Outcomes of interest included 1) six minute walk test (6MWT) and 2) Quality of life (QoL) assessed by Kansas City Cardiomyopathy Questionnaire (KCCQ). Data from each study were combined using the random-effects model to calculate weight mean difference (WMD) and 95% confidence interval (CI)Results:Five studies (4 randomized controlled trials and 1 nonrandomized open-label study) with a total of 1,075 patients (610 in the intervention group and 465 in the control group) were included. In the intervention group, 474 patients received IV iron and 136 patients received oral iron therapy. Iron therapy was associated with significant improvement of 6MWT (WMD =22.81, 95% CI 0.47-45.14, p < 0.001) and KCCQ (WMD =4.68, 95%CI 0.43-8.93, p< 0.001). Interestingly, subgroup analysis showed that the main results were driven by IV iron therapy in both 6MWT (WMD =34.68, 95%CI 25.13-44.24, p< 0.001) and KCCQ (WMD =6.78, 95%CI 3.81-9.75, p< 0.001) as there was no significant improvement after oral iron therapy in 6MWT (WMD =0.15, 95% CI -23.86-24.16, p =0.99) and KCCQ (WMD =2.71, 95% CI-1.35-6.78, p =0.19). As shown in Figure 1.Conclusions:Intravenous iron therapy, but not oral iron therapy is associated with improved exercise capacity and QoL in patients with systolic HF.

Circulation, Volume 146, Issue Suppl_1, Page A12680-A12680, November 8, 2022. Introduction:Whether alcohol consumption increases the risk of atrial fibrillation (AF) recurrence following catheter ablation for AF remains unclear. We aimed to systematically review the medical literature to assess the impact of alcohol consumption on the recurrence of AF following AFHypothesis:Elevated levels of alcohol consumption are associated with increased rates of AF recurrence following AF ablation.Methods:A structured electronic database search (MEDLINE, EMBASE, CONTROL; inception – December 2021) of the scientific literature was performed for studies reporting rates of AF recurrence following catheter ablation stratified by patients’ level of alcohol consumption. Alcohol use was dichotomized into categories which represented moderate-heavy alcohol use or those that represented abstention or rare alcohol use. Study specific odds rations (ORs) were meta-analyzed using a random effects model. Risk of bias was evaluated using the ROBINS-I tool.Results:A total of nine observational studies were identified, which included 5436 patients undergoing catheter ablation. There was substantial variation in the categories used to stratify alcohol consumption. Compared to patients consuming little to no alcohol, patients consuming moderate to high amounts of alcohol had a greater odds of AF recurrence (OR 1.45 [95% CI: 1.06-1.99, p = 0.02]; I2= 79%). This relationship remained significant after exclusion of studies with < 100 participants (OR 1.40, 95% CI 1.03-1.90, p = 0.03) and when abstract-only publications were excluded (OR 1.84, 95% CI 1.21-2.80, p = 0.004). All included studies were found to be at serious risk of bias, mainly due to confounding. There was no evidence of publication bias.Conclusions:Increased alcohol consumption is associated with increased rates of AF recurrence following catheter ablation for AF. Reduction of alcohol consumption post ablation may reduce AF recurrence.

Circulation, Volume 146, Issue Suppl_1, Page A11462-A11462, November 8, 2022. Introduction:Surgical Myectomy (SM) is the gold standard treatment for hypertrophic obstructive cardiomyopathy (HOCM). However, alcohol septal ablation (ASA) has emerged as an alternative option for selected patients. Nonetheless, the long-term efficacy and safety of ASA have been debated in recent years. The aim of this metanalysis is to evaluate the long-term outcomes of ASA vs SM in HOCM patients.Hypothesis:ASA is a safe and effective alternative to SM in HOCM.Methods:: Unrestricted searches of the PubMed, EMBASE, and Cochrane databases from inception till June 1, 2022, for studies comparing long-term outcomes of ASA with SM in HOCM patients. Relevant data were extracted and analyzed using Revman 5.3 software. Odds Ratio (OR) and 95% Confidence interval (CI) were calculated using the random-effects model.Results:: A total of 12 retrospective studies were included examining 7,599 HOCM patients (2,010 ASA vs 5,589 SM). After a mean follow-up of 5.04 years, all-cause mortality was similar between the two groups (OR 1.18; 95% CI 0.60-2.29). However, ASA was associated with high rates of reinterventions (OR 15.68; 95% CI 6.71-36.61), and pacemaker insertion (OR 2.74; 95% CI 1.39-5.41).Conclusions:Although there was no difference in mortality between ASA and SM, ASA was associated with higher rates of reinterventions and pacemaker insertion in long-term follow-up. Therefore, the selection of septal reduction therapy in HOCM should be individualized and should be performed in a comprehensive center after detailed risk and benefits discussions with an experienced team.

Circulation, Volume 146, Issue Suppl_1, Page A12125-A12125, November 8, 2022. Background:In the past year, an implantable pulmonary artery pressure (PAP) sensor with CardioMEMS was approved by the FDA for heart failure (HF) patients with New York Heart Association (NYHA) class III or those with HF-related hospitalization (HFH). However, recent guidelines have not strongly recommended adding the PAP sensor to the standard of care in chronic HF patients.Objectives:We conducted this systematic review and meta-analysis to evaluate whether remote PAP-guided therapy can improve outcomes in chronic HF patients.Methods:We searched MEDLINE and Embase databases from inception to May 2022 to identify studies that compared outcomes of interest, including HFH and all-cause mortality in patients with HF who received remote PAP sensors in addition to the standard of care and those with the standard of care alone. Data from each study were combined using the random-effects model.Results:Four studies (2 randomized controlled trials and 2 matched cohort studies) with 7,505 patients (3,693 in the PAP sensor group and 3,812 in the control group) were included. The use of implantable PAP sensors in patients with chronic HF was associated with significantly lower HFH (hazard ratio (HR) = 0.76, 95% conference interval (CI) 0.68-0.84, p

Circulation, Volume 146, Issue Suppl_1, Page A11762-A11762, November 8, 2022. Background:Considering a paucity of pooled data on the influence of Body Mass Index (BMI) on long-term cardiac outcomes in individuals with Hypertrophic Obstructive Cardiomyopathy(HOCM), we conducted this systematic review.Methods:PUBMED, Scopus, EMBASE and Google Scholar were used to screen studies reporting Mortality/Major Adverse Cardiac Events (MACE) and Sudden Cardiac Death(SCD) among obese vs nonobese HOCM patients. Pooled odds ratios(OR) and heterogeneity were assessed with random-effects models and I2statistics. Subgroup analysis was performed to assess the risk by study type, sample size, country and procedure. The leave-one-study-out method was used for sensitivity analysis.Results:Of the 178 titles screened, we included 13 studies published between 2016-2022 with a total of 2,409,397 HOCM patients followed for a median of 6 years (1.8-8.2 year range). The sample had a higher proportion of males (61.33%) with a mean age of 56.3 years (37-78 year range). The unadjusted [OR=1.55(1.09-2.21), I2=96%] and adjusted [OR=1.28 (1.06-1.54), I2=82.7%] pooled odds of all-cause mortality were significantly higher with increased BMI. On subgroup analyses, prospective studies showed higher odds [n=3, 1.79 (1.23-2.6), p=1000:OR=1.39(1.24-1.57)] but lower sample sizes from other countries [n