No abstract

Mutations in the gene encoding the main cardiac sodium channel (SCN5A) are the commonest genetic cause of Brugada syndrome (BrS). However, the effect of SCN5A mutations on the outcomes of ventricular fibrillation (VF) and syncope remains uncertain. To clarify this relationship, a meta‐analysis was performed. A comprehensive search was conducted to identify all eligible studies from PubMed, MEDLINE, EBSCO, ProQuest, Science Direct, Clinical Key, and Cochrane database for cohort studies of BrS populations that had been systematically tested for SCN5A mutations. We did meta‐analysis to see the relationship between SCN5A mutations and the occurrence of VF and/or syncope using RevMan 5.3. Five clinical studies met our criteria and included a total of 665 BrS patients. These studies included 45 patients with VF and 178 patients with syncope. We found that in BrS patients with SCN5A mutations the rate of VF event was 30.7% while in patients without mutations was 28.5% (Risk Ratio [RR] = 1.11, [95% CI: 0.61, 2.00], P = 0.73, I 2 = 0%). The occurrence of syncope events was 35.9% in patients with SCN5A mutations and 34.5% in patients without mutations (RR = 1.12, [95% CI: 0.87, 1.45], P = 0.37, I 2 = 39%). Furthermore, the occurrence of combined VF and syncope events were similar between the 2 groups (RR = 1.12, [95% CI: 0.89, 1.42], P = 0.34, I 2 = 11%). BrS patients with SCN5A mutations exhibit a similar risk of future occurence of VF and/or syncope as compared to those without SCN5A mutations.

No abstract

Objective: It is speculated that patients with pre-existing use of ACEi/ARB increase the infection risk and severity of COVID-19 pneumonia. Otherwise, the contrasting hypothesis stated that the use of ACEi/ARB might protect against virally induced lung and cardiac injury. We aimed to investigate association between pre-existing use of ACEi/ARB with the severity and mortality in patients with COVID-19 pneumonia. Methods:We performed a comprehensive literature search from several databases in concordance to PRISMA algorithm. The population was COVID-19 pneumonia. Mortality was defi ned as in-hospital mortality; the severity of disease was categorized as severe versus non-severe based on the guidelines issued by National Health Commission of China on Diagnosis and Treatment of COVID-19. Population with pre-existing use of ACEi/ARB and without the use of ACEi/ARB were compared. The primary outcome was mortality, and the secondary outcomes were combined endpoint of mortality and severity.Results: A total of 2,496 patients recruited from 8 eligible studies. This metaanalysis demonstrated that pre-existing use of ACEi/ARB is associated with a lower mortality (RR = 0.81, 95%CI 0.67 to 0.98, p = 0.03, I 2 = 0%). There was no association solely with severity of disease. The use of ACEi/ARB is also associated with the combined endpoint of mortality and severity (RR = 0.87, 95%CI 0.76 to 0.99, p = 0.04, I 2 = 32%). Conclusion:The pre-existing use of ACEi or ARB is associated with lower mortality and the combined endpoint of severity and mortality in patients with COVID-19.