European journal of internal medicine
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Eur. J. Intern. Med. · Jun 2024
Meta AnalysisImpact of early initiation of ezetimibe in patients with acute coronary syndrome: A systematic review and meta-analysis.
Scant data is available on the efficacy and safety of adding ezetimibe to high-intensity statin therapy for early and rapid reduction of low-density lipoprotein cholesterol (LDL-C) within 4-12 weeks of an acute-event in acute coronary syndrome (ACS). We undertook this meta-analysis to address this knowledge-gap. ⋯ Addition of ezetimibe to high-intensity statin therapy at the time of acute coronary syndrome (ACS) index event is associated with significantly better low density lipoprotein cholesterol and total cholesterol reduction at day-7, 1-month, 3-months and 1-year of follow-up, which translates into a significantly lower recurrent cardiovascular events (death from any cause, major ACS, non-fatal stroke, non-fatal myocardial infarction, and ischemic stroke) post an index event of ACS.
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Eur. J. Intern. Med. · Jun 2024
Meta Analysis Comparative StudyComparison of diagnostic spectrum between inflammation of unknown origin and fever of unknown origin: A systematic review and meta-analysis.
Patients with inflammation of unknown origin (IUO) and fever of unknown origin (FUO) are commonly considered a single population. Differences in underlying causes between both groups may steer the diagnostic work-up. ⋯ Based on our findings, there is little reason to assume that FUO and IUO patients would benefit from a different initial diagnostic approach.
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Eur. J. Intern. Med. · Apr 2024
Meta AnalysisRisk of subclinical atherosclerosis in primary Sjogren's syndrome: A systematic review and meta-analysis.
Currently, the guidelines for prevention and management of atherosclerosis in patients with Sjogren's syndrome (SS) do not differentiate from those concerning the general population. ⋯ Patients with pSS have an increased risk of subclinical atherosclerosis compared to healthy population and thus possibly require early and disease-specific intervention. Further research is warranted for more accurate cardiovascular risk management in SS.
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Eur. J. Intern. Med. · Mar 2024
Meta AnalysisEarly prediction of ventilator-associated pneumonia with machine learning models: A systematic review and meta-analysis of prediction model performance✰.
Machine learning-based prediction models can catalog, classify, and correlate large amounts of multimodal data to aid clinicians at diagnostic, prognostic, and therapeutic levels. Early prediction of ventilator-associated pneumonia (VAP) may accelerate the diagnosis and guide preventive interventions. The performance of a variety of machine learning-based prediction models were analyzed among adults undergoing invasive mechanical ventilation. ⋯ A variety of the prediction models, prediction intervals, and prediction windows were identified to facilitate timely diagnosis. In addition, care-related risk factors susceptible for preventive interventions were identified. In future, there is a need for dynamic machine learning models using time-depended predictors in conjunction with feature importance of the models to predict real-time risk of VAP and related outcomes to optimize bundled care.
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Eur. J. Intern. Med. · Jan 2024
Meta AnalysisEfficacy and safety of direct oral anticoagulants vs vitamin K antagonists in patients with atrial fibrillation and end-stage renal disease on hemodialysis: A systematic review and meta-analysis.
The prevalence of atrial fibrillation (AF) in individuals with end-stage renal disease (ESRD) on chronic hemodialysis is increasing. The optimal anticoagulant choice in this population is unclear since these patients were excluded from the pivotal randomized controlled trials (RCTs) of direct oral anticoagulants (DOACs) vs. vitamin K antagonists (VKAs) in the general AF population. We aimed to assess the efficacy and safety of DOACs vs. VKAs in patients with AF and ESRD on chronic hemodialysis through a systematic review and meta-analysis of all available evidence. ⋯ PROSPERO CRD42023391966.