The Racial Disparity Among the Clinical Outcomes Post Stroke and its Intervention Outcomes: A Systematic Review and Meta-analysis

Jaiswal, Vikash; Hanif, Muhammad Abdullah; Ang, Song Peng; Suresh, Vinay; Ruchika, FNU; Momi, Navroop Kaur; Naz, Sidra; Rajak, Kripa; Kumar, Tushar; Naz, Hina; Alvarez, Victor Hugo Alguilera

doi:10.1016/j.cpcardiol.2023.101753

Cited by 5 publications

(5 citation statements)

References 19 publications

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“…There has been an upward trend in the recognition of racial disparities within the field of modern medicine, such as the presence of racial disparities within clinical outcomes poststroke and postcardiac arrest. 9 , 10 With respect to the disparities observed within our meta‐analysis, this could be attributed to the lower rates of hospital arrival via ambulances among non‐White races, leading to a delayed treatment decision and subsequently a delay in anti‐stroke therapy, which puts the patients beyond the 4.5‐h timeframe for receiving tPA. Additionally, stroke awareness and symptom recognition plays a pivotal role in timely hospital arrival, which has been observed to be relatively weaker among the Black population.…”

Section: Discussionmentioning

confidence: 94%

A meta‐analysis on racial disparity in administration of tissue plasminogen activator (tPA) in stroke patients

Larik,

Bhattarai

2024

Health Science Reports

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Section: Discussionmentioning

confidence: 94%

A meta‐analysis on racial disparity in administration of tissue plasminogen activator (tPA) in stroke patients

Larik,

Bhattarai

2024

Health Science Reports

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“…49,50 Finally, in line with previous research, ethnicity influenced the outcome of on ICH. 51,52 The implications of ethnicity encompass various factors, including genetic polymorphisms, 53 differences in healthcare processes 54 and variations in health insurance coverage. 55 The prognostic effect of hemorrhagic locations is controversial.…”

Section: Discussionmentioning

confidence: 99%

More severe initial manifestations and worse short-term functional outcome of intracerebral hemorrhage in the plateau than in the plain

Wang,

Sun,

Wang

et al. 2023

J Cereb Blood Flow Metab

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Intracerebral hemorrhage (ICH) is one of the most devastating forms of stroke. However, studies on ICH at high altitude are insufficient. We aimed to compare the initial manifestations, imaging features and short-term functional outcomes of ICH at different altitudes, and further explore the effect of altitude on the severity and prognosis of ICH. We retrospectively recruited ICH patients from January 2018 to July 2021 from two centers at different altitudes in China. Information regarding to clinical manifestations, neuroimages, and functional outcomes at discharge were collected and analyzed. Association between altitude and initial severity, neuroimages, and short-term prognosis of ICH were also investigated. A total of 724 patients with 400 lowlanders and 324 highlanders were enrolled. Compared with patients from the plain, those at high altitude were characterized by more severe preliminary manifestations ( P < 0.0001), larger hematoma volume ( P < 0.001) and poorer short-term functional outcome ( P < 0.0001). High altitude was independently associated with dependency at discharge (adjusted P = 0.024), in-hospital mortality (adjusted P = 0.049) and gastrointestinal hemorrhage incidence (adjusted P = 0.017). ICH patients from high altitude suffered from more serious initial manifestations and worse short-term functional outcome than lowlanders. Control of blood pressure, oxygen supplementation and inhibition of inflammation may be critical for ICH at high altitude.

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“…This meta‐analysis was conducted and reported following the Cochrane and PRISMA (Preferred Reporting Items for Systematic review and Meta‐Analysis) 2020 guidelines and performed according to established methods, as described previously. 7 , 8 , 9 The prespecified study protocol has been registered in PROSPERO (CRD42023400480).…”

Section: Methodsmentioning

confidence: 99%

“…Over the past few decades, drug development endeavors for HCC have experienced major setbacks, characterized by four global Phase III trials (namely sunitinib, brivanib, linifanib, and erlotinib plus sorafenib) that yielded unsatisfactory results. 7 , 8 , 9 , 10 Specifically, these trials failed to demonstrate non‐inferiority or superiority compared to sorafenib regarding overall survival (OS) as a first‐line treatment for HCC. Sorafenib and lenvatinib are the widely adopted first‐line systemic treatments for advanced HCC.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of lenvatinib versus sorafenib in the primary treatment of advanced hepatocellular carcinoma: A meta‐analysis

Jaiswal,

Hameed,

Naz

et al. 2023

JGH Open

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Background and AimMolecular‐targeted agents such as lenvatinib and sorafenib have been approved to treat hepatocellular carcinoma (HCC). However, the choice between these two agents in the primary treatment for advanced HCC is still under debate with conflicting results. We sought to evaluate the efficacy of lenvatinib and sorafenib in patients with HCC.MethodsWe performed a systematic literature search using PubMed, Embase, and Scopus for relevant articles from inception until February 10, 2023. The primary outcome of this meta‐analysis was overall survival (OS). The secondary outcomes were progression‐free survival (PFS), time to progression, objective response rate (ORR), and disease control rate (DCR).ResultsA total of 13 studies with 3705 patients (1635 on lenvatinib and 2070 on sorafenib) were included in our analysis. The mean age of the patients in both groups was comparable (66.81 vs 65.9 years). Pooled analysis of primary outcomes showed that, compared with sorafenib, lenvatinib was associated with significantly better OS in patients treated with these drugs (HR 0.82, 95% CI: 0.69–0.97, P = 0.02). Pooled analysis also showed that PFS (HR 0.67, 95% CI: 0.57–0.78, P < 0.00001) and time to progression (HR 0.49, 95% CI: 0.31–0.79; P = 0.004) were significantly better in the lenvatinib group compared to the sorafenib group. It also showed that the lenvatinib group had significantly better ORR (odds ratio [OR] 5.43, 95% CI: 3.71–7.97; P < 0.00001) and DCR (OR 2.35, 95% CI: 1.75–3.16; P < 00001) than the sorafenib group.ConclusionOur study shows that lenvatinib is superior to sorafenib regarding OS and PFS in patients with advanced HCC.

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The Racial Disparity Among the Clinical Outcomes Post Stroke and its Intervention Outcomes: A Systematic Review and Meta-analysis

Cited by 5 publications

References 19 publications

A meta‐analysis on racial disparity in administration of tissue plasminogen activator (tPA) in stroke patients

A meta‐analysis on racial disparity in administration of tissue plasminogen activator (tPA) in stroke patients

More severe initial manifestations and worse short-term functional outcome of intracerebral hemorrhage in the plateau than in the plain

Efficacy of lenvatinib versus sorafenib in the primary treatment of advanced hepatocellular carcinoma: A meta‐analysis

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