European journal of preventive cardiology
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Review Meta Analysis
Mind-body practices for patients with cardiac disease: a systematic review and meta-analysis.
Due to new treatment modalities in the last decades, a decline in cardiovascular deaths has been observed. There is an emerging field of secondary prevention and behavioural programmes with increased interest in the use of mind-body practices. Until now, these have not been established in cardiovascular disease treatment programmes. ⋯ Mind-body practices have encouraging results for patients with cardiac disease. Our review demonstrates the need for high-quality studies in this field.
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This systematic review of randomized controlled trials (RCTs) aimed to evaluate the quality of evidence and the strength of recommendation for yoga as an ancillary intervention for heart disease. ⋯ Based on the results of this review, weak recommendations can be made for the ancillary use of yoga for patients with coronary heart disease, heart failure, and cardiac dysrhythmia at this point.
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Review Meta Analysis
Systematic review and meta-analysis of out-of-hospital cardiac arrest and race or ethnicity: black US populations fare worse.
Several studies have reported racial/ethnic variation in out-of-hospital cardiac arrest (OOHCA) characteristics, which engendered varying conclusions. We performed a systematic review and meta-analysed the evidence for differences in OOHCA survival when considering the patient's race and/or ethnicity. ⋯ Our work highlights the significant discrepancy in OOHCA characteristics and patient survival in relation to the patient's race, with the black population faring less well across all stages. Most studies compared black and white populations within the US, so research elsewhere and with other ethnic groups is needed. This review exposes an inequality that demands urgent action.
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Discussions about statin efficacy in cardiovascular prevention are always based on data from blinded randomized controlled trials (RCTs) comparing statin to placebo; however, discussion of side effects is not. Clinicians often assume symptoms occurring with statins are caused by statins, encouraging discontinuation. We test this assumption and calculate an evidence-based estimate of the probability of a symptom being genuinely attributable to the statin itself. ⋯ Only a small minority of symptoms reported on statins are genuinely due to the statins: almost all would occur just as frequently on placebo. Only development of new-onset diabetes mellitus was significantly higher on statins than placebo; nevertheless only 1 in 5 of new cases were actually caused by statins. Higher statin doses produce a detectable effect, but even still the proportion attributable to statins is variable: for asymptomatic liver enzyme elevation, the majority are attributable to the higher dose; in contrast for muscle aches, the majority are not.
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The extent to which individual statins vary in terms of clinical outcomes across all populations, in addition to secondary and primary prevention has not been studied extensively in meta-analyses. ⋯ Statins significantly reduce the incidence of all-cause mortality and major coronary events as compared to control in both secondary and primary prevention. This analysis provides evidence for potential differences between individual statins, which are not fully explained by their low-density lipoprotein cholesterol-reducing effects. The observed differences between statins should be investigated in future prospective studies.