Cardiovascular Risk Following Fertility Therapy

Dayan, Natalie; Filion, Kristian B.; Okano, Marisa; Kilmartin, Caitlin; Reinblatt, Shauna; Landry, Tara; Basso, Olga; Udell, Jacob A.

doi:10.1016/j.jacc.2017.07.753

Cited by 74 publications

(41 citation statements)

References 34 publications

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“…Reported probability values were two-sided, with significance set at p ≤ 0.05. We did not perform the sensitivity analyses because of the limited number of eligible articles ( 33 ).…”

Section: Methodsmentioning

confidence: 99%

Levodopa-Carbidopa Intestinal Gel in Parkinson's Disease: A Systematic Review and Meta-Analysis

Wang

Chen

2018

Front. Neurol.

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Background: Levodopa has been widely used and regarded as the most effective therapy for Parkinson's disease (PD), but long-term treatment with oral levodopa may result in motor fluctuations and involuntary movements (dyskinesias). There is evidence to suggest that Continuous infusion of levodopa-carbidopa intestinal gel (LCIG) can effectively manage motor and non-motor complications in PD, but clinical studies investigating this have yielded inconsistent results. This systematic review and meta-analysis was performed to examine the efficacy and safety of LCIG for patients with PD.Methods: A systematic search was conducted to retrieve published data in the EMBASE, PubMed, and the Cochrane Library up to March 2018. Both efficiency and safety of LCIG were analyzed using pooled standardized mean differences (SMDs) or odds ratio (ORs) with 95% confidence interval (CIs).Results: Eight trials with 384 PD patients were included in the present study. Compared with the control group, LCIG significantly decreased off-time (SMD, −1.19; 95% CI, −2.25 to −0.12; p = 0.003) and increased on-time without troublesome dyskinesia (SMD, 0.55; 95% CI, 0.20 to 0.90; p = 0.002). However, no significant difference of LCIG was found in on-time with troublesome dyskinesia. There were no significant differences in UPDRS, Hoehn & Yahr and PDQ-39 scores. Besides, no significant differences in the drop-out and adverse effects.Conclusions: Continuous delivery of LCIG may offer a promising option for PD patients. More randomized double-blind controlled studies with large sample sizes were needed to further confirm the efficacy and safety of LCIG for PD patients.

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“…Reported probability values were two-sided, with significance set at p ≤ 0.05. We did not perform the sensitivity analyses because of the limited number of eligible articles ( 33 ).…”

Section: Methodsmentioning

confidence: 99%

Levodopa-Carbidopa Intestinal Gel in Parkinson's Disease: A Systematic Review and Meta-Analysis

Wang

Chen

2018

Front. Neurol.

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“…p ≤ 0.05 was considered as statistical significant. Publication bias and sensitivity analyses were not conducted because of the limited number of included studies [ 19 , 20 ].…”

Section: Methodsmentioning

confidence: 99%

Cetuximab for esophageal cancer: an updated meta-analysis of randomized controlled trials

Huang

Zhang

et al. 2018

BMC Cancer

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BackgroundIncreasing evidence indicates that cetuximab (CET) combined with chemoradiotherapy may be effective for patients with esophageal cancer. However, the recent results are still contradictory and no consensus has yet been reached on this issue. To evaluate the clinical effects and safety of CET, we conducted an updated meta-analysis by retrieving published data up to June 2018.MethodsA comprehensive literature search was performed in several electronic databases, including PubMed, Embase, the Cochrane Library, CNKI database and Chinese Biomedicine Database using subject terms and free terms. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to determine the efficiency and safety of CET.ResultsThis meta-analysis included 10 randomized controlled trials (RCTs). Five RCTs reported localized esophageal cancer and other five RCTs reported metastatic esophageal cancer. For these patients with localized esophageal cancer, CET could not significantly improve the response rate, overall survival and progression-free survival (PFS, 1–5 years). But CET treatment might increase the incidences of diarrhea (OR = 2.07; CI = 1.01–4.25) and rash (OR = 16.91; CI = 3.20–89.42). For other patients with metastatic esophageal cancer, the addition of CET significantly increased the response rate (OR = 3.34; CI = 1.90–5.88), disease control rate (OR = 2.92; CI = 1.49–5.71) and 2-year overall survival (OR = 2.78; CI = 1.20–6.46) compared with the control group. However, CET could not improve the 1-year overall survival and might make patients with metastatic esophageal cancer more susceptible to rash (OR = 5.50; CI = 2.14–14.14). No significant differences in other adverse effects were found between the two groups.ConclusionsOur findings suggested that adding CET to multimodal therapy significantly improved response rate and disease control rate for patients with metastatic esophageal cancer rather than patients with localized esophageal cancer. CET might be a safe therapeutic choice, but CET failed to significantly improve the overall survival and PFS for patients with localized or metastatic esophageal cancer.

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“…However, IVF has been shown to result in adverse fetal events such as increased risk of development of congenital heart defect, hypertension, and vascular dysfunction. [6][7][8][9] ART treatment can also lead to fatal peripartum cardiomyopathy in pregnant women. 10 In addition, fertility therapy increases the risk of SCAD during pregnancy.…”

Section: Cad During Pregnancymentioning

confidence: 99%

Pregnancy and cardiac interventions: What are the optimal management options?

et al. 2020

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Cardiac disease is the leading cause of maternal mortality in the United Kingdom. Major causes of cardiac death in pregnant women include cardiomyopathies, myocardial infarction, ischemic heart disease, and aortic dissection. Uncorrected congenital heart disease and women who have had corrective or palliative surgery may have complicated pregnancies as well. Some women with significant cardiac disease are unable to meet the increased physiological demands of pregnancy. Of these, those who do not respond to medical treatment may require surgical correction such as coronary artery bypass grafting. The risk of cardiac operations for pregnant women is similar to that for nonpregnant women but the fetal mortality rate remains high. Contributing factors to high fetal mortality rates include timing, urgency of operation, and the fetal/fetoplacental response to cardiopulmonary bypass. The aim of this review is to summarize current evidence in utilizing the different management approaches of cardiac issues during pregnancy.

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Cardiovascular Risk Following Fertility Therapy

Abstract: The small number of studies and significant heterogeneity precludes definitive reassurance about the longer term cardiovascular safety of these treatments, particularly stroke. Future studies are needed to address ongoing knowledge gaps in this area.

Cited by 74 publications

References 34 publications

Levodopa-Carbidopa Intestinal Gel in Parkinson's Disease: A Systematic Review and Meta-Analysis

Levodopa-Carbidopa Intestinal Gel in Parkinson's Disease: A Systematic Review and Meta-Analysis

Cetuximab for esophageal cancer: an updated meta-analysis of randomized controlled trials

Pregnancy and cardiac interventions: What are the optimal management options?

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