RESUMEN

BACKGROUND: COPD is often accompanied by extra-pulmonary manifestations such as thrombo-embolic and hemorrhagic events, the disease is linked with atrial fibrillation (AF). OBJECTIVE: The objective of the current review was to assess the impact of chronic obstructive pulmonary disease (COPD) on outcomes of atrial fibrillation (AF). METHODS: PubMed, Scopus, Embase, and Web of Science databases were searched for studies comparing overall mortality, cardiovascular death, and other outcomes for AF patients with and without COPD. The data retrieved were subjected to both qualitative and quantitative analyses. The hazard ratios (HR) obtained for mortality in presence of COPD were pooled to meta-analyze using generic inverse variance function of RevMan 5.3 software. The association of various risk factors and HRs were pooled with 95% confidence interval (CI). The quality of the included studies was assessed using Newcastle Ottawa scale (NOS). RESULTS: The hazard ratios (HR) were calculated with 95% confidence intervals (CIs). A total of seven studies were included. The pooled HR for the impact of COPD on overall mortality and cardiovascular mortality in AF patients was found to be 1.70 (95% CI: 1.47, 1.97; p<0.0001) and 1.80 (95% CI: 1.29, 2.52; p = 0.0005), respectively. Hemorrhagic events were significantly higher in AF patients with COPD (Odds ratio (OR): 1.84; 95% CI: 1.58, 2.14; p<0.00001). CONCLUSION: COPD has a deleterious impact on AF progression in terms of overall mortality, cardiovascular death, stroke and hemorrhagic complications.

Asunto(s)

RESUMEN

A study on 70 acute lymphoblastic leukemia (ALL) children (age ≤16 years) treated with high-dose methotrexate (HD-MTX) in Sichuan Provincial People's Hospital was conducted. The aim of the study was to establish a risk-scoring model to predict HD-MTX-induced liver injury, considering gene polymorphisms' effects. Data screening was performed through t-test, chi-square test, and ridge regression, and six predictors were identified: age, MTRR_AA, MTRR_AG, SLCO1B1_11045879_CC, albumin_1 day before MTX administration, and IBIL_1 day before MTX administration (p < 0.1). Then, the risk-scoring model was established by ridge regression and evaluated the prediction performance. In a training cohort (n = 49), the area under the curve (AUC) was 0.76, and metrics including accuracy, precision, sensitivity, specificity, positive predictive value, and negative predictive value were promising (0.86, 0.81, 0.76, 0.91, 0.81, 0.88, respectively). In a test cohort (n = 21), the AUC was 0.62 and negative predictive value was 0.80; other evaluation metrics were not satisfactory, possibly due to the limited sample size. Ultimately, the risk scores were stratified into three groups based on their distributions: low- (≤48), medium- (49-89), and high-risk (>89) groups. This study could provide knowledge for the prediction of HD-MTX-induced liver injury and reference for the clinical medication.

RESUMEN

OBJECTIVES: The effect of methotrexate (MTX)-related adverse reaction on hematologic neoplasms patients is controversial. We performed this meta-analysis to assess the association between methylenetetrahydrofolate reductase (MTHFR) C677T/A1298C polymorphism and the adverse reaction after MTX using. METHODS: We searched for qualified studies according to PubMed, the Cochrane Library, and the Web of Science. The meta-analysis was performed by Review Manager 5.3. The analysis was conducted to compare risk ratios (RRs) with the corresponding 95% confidence interval (95% CI) to evaluate the relationship between different toxicity reactions and the genotype of MTHFR. RESULTS: We included 17 studies which satisfied with the criteria in this meta-analysis. The results of our statistical analysis showed that no significant correlation between MTHFR C677T/A1298C genetic polymorphism and patients' toxicity or the relapse and survival associated with MTX chemotherapy (P > .05). But we observed that a tendency toward increased risk of hepatotoxicity was also present for acute lymphoblastic leukemia in the mutation model (CT/TT vs. CC: RR: 1.92, 95% CI: 1.01-3.67; P = .05). CONCLUSION: The polymorphism of MTHFR C677T/A1298C may not be an important indicator for the accurate detection of side effects of chemotherapy after using MTX. More relative research is needed.

Asunto(s)