Alcohol and ischemic heart disease: wine,beer or both?

The relationship between mortality from ischemic heart disease and alcoholic beverage consumption in 27 countries was investigated. A significant inverse correlation was obtained between mortality due to ischemic disease and percent contribution to alcohol consumption by wine (r = -0.75, P less than 0.001). A positive correlation (r = 0.60, P less than 0.001) was obtained between ischemic heart disease and alcohol consumption from beer.     

Diabetes mellitus and risk of hepatocellular carcinoma: a systematic review and meta-analysis

Studies of diabetes and hepatocellular carcinoma (HCC) yielded inconsistent findings. This meta-analysis was conducted to examine the association between diabetes and risk of HCC. Studies were identified by searching PUBMED and MEDLINE database up to February 2011. Pooled risk estimates were calculated using the random-effects model. Potential sources of heterogeneity were explored by subgroup analyses. A total of 17 case-control studies and 32 cohort studies were included in the meta-analysis. The combined risk estimate of all studies showed a statistically significant increased risk of HCC prevalence among diabetic individuals (RR?=?2.31, 95% CI: 1.87-2.84). The pooled risk estimate of 17 case-control studies (OR?=?2.40, 95% CI: 1.85-3.11) was slightly higher than that from 25 cohort studies (RR?=?2.23, 95% CI: 1.68-2.96). Metformin treatment was potentially protective. On the contrary, long duration of diabetes and sulfonylureas or insulin treatment possibly increase HCC risk. Also meta-analysis of 7 cohort studies found a statistically significant increased risk of HCC mortality (RR?=?2.43, 95% CI: 1.66-3.55) for individuals with (versus without) diabetes. This meta-analysis shows that diabetes is associated with moderately increased risk of HCC prevalence, as well as HCC mortality. Considering the rapidly increasing prevalence of diabetes mellitus, the study underlines the need for cancer prevention in diabetic individuals. Further investigation is needed to focus on the potential mechanism for the pathogenesis of HCC and the link between HCC and different types, severity, treatment and duration of diabetes.     

Different measures of alcohol consumption and risk of coronary heart disease and all-cause mortality: 11-year follow-up of the Whitehall II Cohort Study

Aims To investigate the relationship between three measures of alcohol consumption obtained simultaneously in a large cohort and the validated risk of coronary heart disease and all‐cause mortality during follow‐up. Design Prospective cohort study with median follow‐up of 11 years. Setting The Whitehall II Cohort Study: London‐based civil service. Participants A total of 10 308 (33% female) civil servants aged 35–55 years at baseline (1985–88). Measurements Self‐reported volume of alcohol consumed during past week, frequency of drinking over past year, usual amount consumed per drinking session. Main outcome measures Coronary heart disease and all‐cause mortality until 1999. Findings A U‐shaped relationship was found between volume of alcohol consumed per week and outcome. Compared to those who drank moderately (10–80 g alcohol per week), non‐drinkers and those drinking more than 248 g per week had approximately a twofold increased risk of mortality. The optimal frequency of drinking was between once or twice a week and daily, after adjustment for average volume consumed per week. Those drinking twice a day or more had an increased risk of mortality (male hazard ratio 2.44 95% CI 1.31–4.52) compared to those drinking once or twice a week. Drinking only once a month or only on special occasions had a 50% increased risk of mortality. The usual amount consumed per drinking session was not indicative of increased health risk in this cohort. Conclusions Epidemiological studies should collect information on frequency of drinking in addition to average volume consumed in order to inform sensible drinking advice.     

Alcohol consumption and cardiovascular mortality accounting for possible misclassification of intake: 11-year follow-up of the Melbourne Collaborative Cohort Study

AIMS: To investigate the relationship between usual daily alcohol intake, beverage type and drinking frequency on cardiovascular (CVD) and coronary heart disease (CHD) mortality, accounting for systematic misclassification of intake. DESIGN: Prospective cohort study with mean follow-up of 11.4 years. Setting The Melbourne Collaborative Cohort Study, Australia. PARTICIPANTS: A total of 38 200 volunteers (23 044 women) aged 40-69 years at baseline (1990-1994). MEASUREMENTS: Self-reported alcohol intake using beverage-specific quantity-frequency questions (usual intake) and drinking diary for previous week. FINDINGS: Compared with life-time abstention, usual daily alcohol intake was associated with lower CVD and CHD mortality risk for women but not men. For women, the hazard ratio [HR (95% CI)] for CVD for those drinking > 20 g/day alcohol was 0.43 (0.19-0.95; P trend = 0.18), and for CHD, 0.19 (0.05-0.82; P trend = 0.24). Male former drinkers had over twice the mortality risk for CVD [HR = 2.58 (1.51-4.41)] and CHD [HR = 2.91 (1.59-5.33)]. Wine was the only beverage associated inversely with mortality for women. Compared with drinkers who consumed no alcohol in the week before baseline, drinking frequency was associated inversely with CVD and CHD mortality risk for men but not women. HR for men drinking 6-7 days/week was 0.49 (0.29-0.81; P trend = 0.02) for CVD, and 0.49 (0.26-0.92: P trend = 0.23) for CHD. CONCLUSIONS: Usual daily alcohol intake was associated with reduced CVD and CHD mortality for women but not men. This benefit appeared to be mainly from wine, although comparison of beverages was not possible. Drinking frequency was associated inversely with CVD and CHD death for men but not women.     

Benefit and risk of adding rivaroxaban in patients with coronary artery disease: A systematic review and meta‐analysis

BackgroundAlthough the European Medicines Agency and the US Food and Drug Administration have, respectively, approved rivaroxaban for the prevention of recurrent major adverse cardiovascular events in patients with myocardial infarction and stable coronary artery disease, its efficacy and safety is unclear. This meta‐analysis aimed to evaluate the benefit and risk of adding rivaroxaban in coronary artery disease (CAD) patients, focusing on treatment effects stratified by different baseline clinical presentations.HypothesisThere are differences in treatment effects of adding rivaroxaban among CAD patients with different baseline clinical presentations.MethodsMedline, EMBASE, and Cochrane Databases were systematically searched from inception to 21 July 2020 for randomized controlled trials (RCTs) comparing rivaroxaban in CAD patients. The primary efficacy endpoint and safety endpoint were assessed by using Mantel–Haenszel pooled risk ratios (RRs) and 95% confidence intervals (CIs).ResultsFive RCTs that included 43 650 patients were identified. Patients receiving rivaroxaban had a significantly lower risk of the primary efficacy endpoint (RR, 0.86; 95% CI, 0.76–0.97, p = .01) accompanied by increased risk of the primary safety endpoint (RR, 1.83; 95% CI, 1.10–3.05, p = .02). Subgroup analyses showed that in males the risk–benefit appears to be more favorable while in patients ≥65 years, in females, in patients with diabetes, those with mild to moderate impaired renal function, and region of Asia/other seems unfavorable.ConclusionRivaroxaban may provide an additional choice for secondary prevention in CAD patients. However, careful estimation of the risk of ischemic and bleeding events using patient characteristics are critical to achieving net benefit.     

The association between hyperuricemia and coronary artery calcification development: A systematic review and meta‐analysis

Hyperuricemia coincides with coronary artery calcification (CAC) development, but the role of serum uric acid (SUA) as a risk factor for CAC remains unclear. The objective of this study was to gain an insight into the association between SUA and CAC in adults by performing a meta‐analysis. MEDLINE, EMBASE, the Cochrane Library, and EBSCO (CINAHL) were searched for relevant observational studies published until 2 June 2019. Studies were included only if they reported data on CAC presence (Agatston score > 0) or progression related to hyperuricemia in subclinical adult patients. The pooled estimates of crude and adjusted odds ratios (ORs) and 95% confidence interval (CI) were calculated to evaluate the association between CAC presence or progression and hyperuricemia. A total of 11 studies were identified involving 11 108 adults. The pooled OR based on the frequency of CAC presence showed that patients in the high SUA group had 1.806‐fold risk for developing CAC (95% CI: 1.491‐2.186) under the minimal threshold of hyperuricemia (more than 6 mg/dL or 357 μmoL/L). When SUA levels were analyzed as categorical variables, the pooled estimate of adjusted ORs was 1.48 (95% CI: 1.23‐1.79) for CAC presence. Additionally, for each increase of 1 mg/dL of SUA level, the risk of CAC progression was increased by 31% (95% CI: 1.15‐1.49) with an average follow‐up duration ranged from 4.6 to 6.1 years. Hyperuricemia is closely associated with increased risk of CAC development and CAC progression in asymptomatic patients.     

Hepatitis B virus infection increases the risk of cholangiocarcinoma: A meta-analysis and systematic review

Background and Aim: A number of studies have shown that hepatitis virus infections may be associated with cholangiocarcinoma (CC). However, the relationship between hepatitis B virus (HBV) infection and CC, especially intrahepatic cholangiocarcinoma (ICC), is still controversial. Methods: Relevant studies were identified by searching PUBMED, EMBASE and Web of Science Datebases up to September 2011. Pooled risk estimates were calculated using a random-effects model. Potential sources of heterogeneity were performed by subgroup analyses. A total of 18 papers were included in this meta-analysis. Results: The pooled risk estimate of all studies showed a statistically significant increased risk of CC among individuals with HBV infection (rate ratio [RR]: 2.66; 95% confidence interval [CI]: 1.97, 3.60). Compared with those without HBV infection, persons with HBV infection had an increased risk of intra-CC (ICC) (RR: 3.42; 95% CI: 2.46, 43.74), extrahepatic CC (OR: 1.46; 95% CI: 0.98, 2.17), and CC (OR: 2.03; 95% CI: 1.15, 3.56). In a subgroup analysis of HBV infection and risk of ICC, the pooled risk estimate of studies in Asians (RR: 3.63; 95% CI: 2.56, 5.13) was higher than that in non-Asians (RR: 1.93; 95% CI: 0.78, 4.76). A Begg funnel plot and Egger test revealed no evidence for publication bias. Conclusions: This meta-analysis shows that HBV is associated with increased risk of CC, especially for ICC. Further investigation is needed to focus on the mechanism by which HBV may be involved in the pathogenesis of CC.     

东亚男性饮酒与冠心病的关系

目的 探讨东亚男性饮酒对冠心病发病率、病死率和全因死亡率的影响.方法 检索Pubmed等数据库,纳入中国、日本、韩国符合入选条件的前瞻性队列研究.记录研究来源国家,例数,性别,年龄,随访期限,饮酒量,与饮酒相关的冠心病发病率、病死率及全因死亡率的相对风险等资料.应用荟萃分析,系统评价饮酒量与冠心病发病率、病死率及全国死亡率的风险效应.结果 纳入前瞻性队列研究15项;共计汇总冠心病研究对象177 723例,含冠心病患者2406例;全因死亡研究对象216 233例,含各种原因死亡15 462例.与不饮酒者比较,每日饮酒量≤20、21～40、41～60、＞60g/d者冠心病发病风险分别为0.65(95%CI:0.34～1.23,P=0.18)、0.48(95%CI:0.26～0.87,P=0.02)、0.46(95%CI:0.32～0.67,P＜0.01)和0.48(95%CI:0.29～0.78,P＜0.01),冠心病死亡风险分别为0.98(95%CI:0.73～1.31,P=0.87)、0.68(95%CI:0.58～0.79,P＜0.01)、0.64(95%CI:0.43～0.96,P=0.03)和0.75(95%CI:0.54～1.03,P=0.08),全因死亡风险分别为0.83(95%CI:0.79～0.91,P＜0.01)、0.93(95%CI:0.87～0.99,P=0.03)、1.01(95%CI:0.95～1.07,P=0.86)和1.32(95%CI:1.29～1.36,P＜0.01).结论 东亚男性适量饮酒可降低冠心病发病率及病死率.随着饮酒量增加,全因死亡的风险明显增加.每日饮用酒精量不应超过40g.     

Adiponectin and incident coronary heart disease and stroke. A systematic review and meta‐analysis of prospective studies

The plasma concentration of adiponectin, an adipokine that has anti‐inflammatory, anti‐atherogenic and insulin sensitizing properties, is lower in obese subjects and could therefore be a target for therapy. In order to review and meta‐analyse prospective cohort studies investigating adiponectin concentration and the risk for incident coronary heart disease (CHD) or stroke, a systematic search of MEDLINE, EMBASE and Cochrane databases was performed. Two independent reviewers selected prospective cohort studies investigating the relationship between adiponectin level and incident CHD or stroke using ‘adiponectin’ and ‘cardiovascular disease’ or ‘stroke’ and their synonyms, excluding patients with clinically manifest vascular disease. Random‐effects models were used to calculate pooled relative risks (RRs) and 95% confidence intervals (95% CI). Generalized least squares regression was used to assess dose–response relationships for adiponectin concentrations from studies that provided RRs solely based upon categorical data regression. In total, 16 prospective cohort studies, comprising 23,919 patients and 6,870 CHD or stroke outcome events, were included in the meta‐analyses. An increase of 1 standard deviation in log‐transformed adiponectin did not lower the risk for CHD (RR 0.97; 95% CI 0.86–1.09). A 10 μg mL^–1 increase in adiponectin conferred a RR of 0.91 (95% CI 0.80–1.03) for CHD and a RR 1.01 (95% CI 0.97–1.06) for stroke. In conclusion, plasma adiponectin is not related to the risk for incident CHD or stroke.     

Compound Danshen dripping pills in treating with coronary heart disease: A protocol for systematic review and meta-analysis

Background:Coronary heart disease (CHD) patients are categorized by occlusion or vascular stenosis leading to myocardial ischemia, hypoxia, and necrosis. In clinical cardiovascular, CHD remains as a leading disease that is primarily prevalent among older people and mid-aged groups. CHD has a drastic impact on their life standard, and is known to have debilitating effects on both mental and physical wellbeing. As a Chinese patent medicine, compound Danshen dripping pills (CDDPs) are commonly administered to treat CHD in China. Despite the common intake of CDDPs, there is a lack of evidence-based clinical practice to inform its efficacy and safety through related systematic reviews. Therefore, the present protocol proposes to conduct a meta-analysis aiming to evaluate the effectivity and safeness of using CDDP for treating CHD patients.Methods:Randomized controlled trials that have evaluated the efficacy and safety of CDDP for treating CHD patients will be searched in MEDLINE, Cochrane Library, EMBASE, China National Knowledge Infrastructure, and WanFang databases. The search will include all related articles published till January 3, 2022. The extracted data will include information on study design, characteristics of the participants, details on intervention, and outcomes. Cochrane risk of bias tool will be employed to assess the quality of the trials. We will use either a random-effects model or fixed-effects model to pool the data. We will present the results as a risk ratio for dichotomous data and weighted mean difference for continuous data. We will visualize publication bias using funnel plots. Disagreements shall be resolved through discussion.Ethics and dissemination:Not required.OSF registration number:10.17605/OSF.IO/HJTP8     

Moderate alcohol drinking might be protective for systemic lupus erythematosus: a systematic review and meta-analysis

Conflicting evidence for the effect of moderate alcohol drinking on the development of systemic lupus erythematosus (SLE) existed at present. In the current study, we performed an extensive search of relevant studies and performed a meta-analysis to obtain a more precise estimate. Thirty-eight studies were identified from electronic databases and chosen for detailed review, then six articles from six case–control studies with one cohort study were included in our meta-analyses. Meta-analyses were divided into two subgroups in which patients in the study of Washio et al. treated for less than 5 years (subgroup A) or less than 10 years (subgroup B) were involved, respectively. The odds ratio (OR) of moderate alcohol drinking in the meta-analyses of subgroup B for the development of SLE was significantly decreased (OR 0.723, 95% confidence interval (95% CI) 0.547–0.954), while moderate alcohol drinking in the meta-analysis of subgroup A did not demonstrate a decreased risk of SLE (OR 0.780, 95% CI 0.491–1.240). Meta-analyses of six case–control studies in the two subgroups both demonstrated that moderate alcohol drinking had a protective effect on the development of SLE. Taken together, our results show that moderate alcohol drinking might be protective for SLE. Jing Wang and Hai-Feng Pan contributed equally to this work and should be considered co-first authors.     

The relationship of average volume of alcohol consumption and patterns of drinking to burden of disease: an overview

Aims As part of a larger study to estimate the global burden of disease attributable to alcohol:

• ? to quantify the relationships between average volume of alcohol consumption, patterns of drinking and disease and injury outcomes, and
• ? to combine exposure and risk estimates to determine regional and global alcohol‐attributable fractions (AAFs) for major disease and injury categories.

Design, methods, setting Systematic literature reviews were used to select diseases related to alcohol consumption. Meta‐analyses of the relationship between alcohol consumption and disease and multi‐level analyses of aggregate data to fill alcohol–disease relationships not currently covered by individual‐level data were used to determine the risk relationships between alcohol and disease. AAFs were estimated as a function of prevalence of exposure and relative risk, or from combining the aggregate multi‐level analyses with prevalence data. Findings Average volume of alcohol consumption was found to increase risk for the following major chronic diseases: mouth and oropharyngeal cancer; oesophageal cancer; liver cancer; breast cancer; unipolar major depression; epilepsy; alcohol use disorders; hypertensive disease; hemorrhagic stroke; and cirrhosis of the liver. Coronary heart disease (CHD), unintentional and intentional injuries were found to depend on patterns of drinking in addition to average volume of alcohol consumption. Most effects of alcohol on disease were detrimental, but for certain patterns of drinking, a beneficial influence on CHD, stroke and diabetes mellitus was observed. Conclusions Alcohol is related to many major disease outcomes, mainly in a detrimental fashion. While average volume of consumption was related to all disease and injury categories under consideration, pattern of drinking was found to be an additional influencing factor for CHD and injury. The influence of patterns of drinking may be underestimated because pattern measures have not been included in many epidemiologic studies. Generalizability of the results is limited by methodological problems of the underlying studies used in the present analyses. Future studies need to address these methodological issues in order to obtain more accurate risk estimates.     

Evaluation of efficacy and safety of aspirin combination treatment in treating patients with coronary heart disease: A protocol for systematic review and meta-analysis

Background:Coronary heart disease (CHD) has a high incidence rate as a cardiovascular condition, primarily affecting the elderly and middle-aged individuals. CHD has debilitating effects on the standard of life of the elderly, and affecting their physical and psychological health. Reportedly, using aspirin alone is less effective as a first line of treatment for CHD. Therefore, this systematic review and meta-analysis will synthesize evidence on the effectiveness and safeness of aspirin combination treatment in treating patients with CHD.Methods:A comprehensive meta-analysis is to be performed to evaluate the effectiveness and safety of aspirin combination treatment for CHD patients. A search will be performed on PubMed, EMBASE, Cochrane Central, WanFang, and Chinese National Knowledge Infrastructure till December 25, 2021 to identify randomized controlled trials, assess all related studies on the aspirin combination treatment in treating patients with CHD. In this systematic review, we will adopt the second version of Cochrane risk of bias assessment tool to assess the bias risk in all studies that fulfil the eligibility conditions. Two authors will separately conduct the study selection process, risk of bias assessment, and data extraction. Moreover, a random-effects meta-analysis will be conducted to synthesize evidence for all outcomes. Provided there is sufficient homogeneity among the studies, we will perform meta-analysis. I ² test will be employed to assess the heterogeneity of the outcomes.OSF registration number:10.17605/OSF.IO/MDTCA