LBPMC Group publications
 
Effects of Quercetin on Blood Pressure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Quercetin, the most abundant dietary flavonol, has antioxidant effects in cardiovascular disease, but the evidence regarding its effects on blood pressure (BP) has not been conclusive. We assessed the impact of quercetin on BP through a systematic review and meta-analysis of available randomized controlled trials.
 
Comparison of clinical outcomes between bioresorbable vascular stents versus conventional drug-eluting and metallic stents: a systematic review and meta-analysis.
Several studies have suggested good procedural and similar clinical outcomes between everolimus eluting Absorb bioresorbable stents (BRS) versus conventional drug-eluting stents (DES), but the evidence is not definitive. Our aim was to perform a systematic review and meta-analysis to investigate the effects of BRS versus conventional drug-eluting and bare metallic stents on the cardiovascular endpoints and all cause mortality.
 
Does vitamin D supplementation alter plasma adipokines concentrations? A systematic review and meta-analysis of randomized controlled trials.
We aimed to elucidate the role of vitamin D supplementation on adipokines through a systematic review and a meta-analysis of randomized placebo-controlled trials (RCTs). The search included PUBMED, Scopus, Web of Science and Google Scholar through July 1st, 2015. Finally we identified 9 RCTs and 484 participants.
 
Lipoprotein(a) Levels in Patients With Abdominal Aortic Aneurysm: A Systematic Review and Meta-Analysis.
Circulating markers relevant to the development of abdominal aortic aneurysm (AAA) are currently required. Lipoprotein(a) (Lp(a)) is considered a candidate marker associated with the presence of AAA. The present meta-analysis aimed to evaluate the association between circulating Lp(a) levels and the presence of AAA.
 
Impact of L-carnitine on plasma lipoprotein(a) concentrations: A systematic review and meta-analysis of randomized controlled trials.
We aimed to assess the impact of L-carnitine on plasma Lp(a) concentrations through systematic review and meta-analysis of available RCTs. The literature search included selected databases up to 31st January 2015.
 
The impact of statin therapy on plasma levels of von Willebrand factor antigen. Systematic review and meta-analysis of randomised placebo-controlled trials.
Increased plasma levels of von Willebrand factor antigen (vWF:Ag) are associated with high risk of coronary artery disease. The effect of statin therapy on vWF:Ag levels remains uncertain. Therefore the aim of this meta-analysis was to evaluate the effect of statin therapy on vWF:Ag Levels.
 
Head-to-head comparison of statins versus fibrates in reducing plasma fibrinogen concentrations: A systematic review and meta-analysis.
Several studies suggest differences between fibrates and statins in lowering plasma fibrinogen (Fib) concentrations, but the evidence is not definitive. Therefore, the aim of this meta-analysis of head-to-head randomized trials was to compare the efficacy of statins and fibrates on plasma Fib concentrations.
 
Impact of statin therapy on coronary plaque composition: a systematic review and meta-analysis of virtual histology intravascular ultrasound studies.
Virtual histology intravascular ultrasound (VH-IVUS) imaging is an innovative tool for the morphological evaluation of coronary atherosclerosis. Evidence for the effects of statin therapy on VH-IVUS parameters have been inconclusive. Consequently, we performed a systematic review and meta-analysis to investigate the impact of statin therapy on plaque volume and its composition using VH-IVUS.
 
Statin Therapy and Plasma Coenzyme Q10Concentrations - A Systematic Review and Meta-Analysis of Placebo-Controlled Trials.
Statin therapy may lower plasma coenzyme Q10 (CoQ10) concentrations, but the evidence as to the significance of this effect is unclear. We assessed the impact of statin therapy on plasma CoQ10 concentrations through the meta-analysis of available RCTs.
 
Sleep changes following statin therapy: a systematic review and meta-analysis of randomized placebo-controlled polysomnographic trials.
Statin use might be associated with an increased risk of sleep disturbances including insomnia, but the evidence regarding sleep changes following statin therapy has not been conclusive. Therefore we assessed the impact of statin therapy on sleep changes through a systematic review and meta-analysis of available randomized controlled trials (RCTs).
 
Tibolone decreases Lipoprotein(a) levels in postmenopausal women: A systematic review and meta-analysis of 12 studies with 1009 patients.
Circulating Lp(a) is a recognized risk factor for cardiovascular disease (CVD). Tibolone may lower Lp(a), however, evidence of this effect remains to be confirmed. Meta-analysis suggests a significant Lp(a) reduction following tibolone (by 25.28%). Further studies are warranted to explore the mechanism of this effect. A place of tibolone in individuals at CVD risk needs to be further investigated.
 
Statin therapy reduces plasma endothelin-1 concentrations: A meta-analysis of 15 randomized controlled trials.
Raised plasma endothelin-1 (ET-1) levels may be a risk factor for vascular dysfunction and cardiovascular (CV) disease. This meta-analysis assessed the effect of statins on circulating ET-1 concentrations.
 
A systematic review and meta-analysis of the effect of statins on plasma asymmetric dimethylarginine concentrations.
The impact of statin therapy on plasma asymmetric dimethylarginine (ADMA) levels has not been conclusively studied. Therefore the aim of the meta-analysis was to assess the effect of statins on circulating ADMA levels.
 
Effects of flaxseed supplements on blood pressure: A systematic of review and meta-analysis of controlled clinical trial.
Many experimental and clinical trials suggested that flaxseed might be a potent antihypertensive, but the evidences concerning the effects of flaxseed supplements on blood pressure (BP) has not been fully conclusive. We aimed to assess the impact of the effects of flaxseed supplements on blood pressure through systematic review of literature and meta-analysis of available randomized controlled trials (RCTs).
 
Association between statin use and plasma D-dimer levels. A systematic review and meta-analysis of randomised controlled trials.
D-dimers, specific breakdown fragments of cross-linked fibrin, are generally used as circulating markers of activated coagulation. Statins influence haemostatic factors, but their effect on plasma D-dimer levels is controversial. Therefore, the aim of this meta-analysis was to evaluate the association between statin therapy and plasma D-dimer levels.
 
Lack of efficacy of resveratrol on C-reactive protein and selected cardiovascular risk factors - Results from a systematic review and meta-analysis of randomized controlled trials.
Numerous studies have suggested that oral supplementation with resveratrol exerts cardioprotective effects, but evidence of the effects on C-reactive protein (CRP) plasma levels and other cardiovascular (CV) risk factors is inconclusive. Therefore, we performed a meta-analysis to evaluate the efficacy of resveratrol supplementation on plasma CRP concentrations and selected predictors of CV risk.
 
In reply - Coenzyme Q10 and Statin-Induced Myopathy.
This is the reply to the letters by Drs Keller and Braillon to our meta-analysis on CoQ(10) and statin-induced myopathy.
 
Effects of Coenzyme Q10 on Statin-Induced Myopathy: A Meta-analysis of Randomized Controlled Trials.
The aim of the meta-analysis was to evaluate the efficacy of coenzyme Q10 (CoQ10) supplementation on statin-induced myopathy. We searched the MEDLINE, Cochrane Library, Scopus, and EMBASE databases (up to May 1, 2014) to identify randomized controlled trials investigating the impact of CoQ10 on muscle pain and plasma creatine kinase (CK) activity as 2 measures of statin-induced myalgia. The results of this meta-analysis of available randomized controlled trials do not suggest any significant benefit of CoQ10 supplementation in improving statin-induced myopathy. Larger, well designed trials are necessary to confirm the findings from this meta-analysis.
 
Analysis of vitamin D levels in patients with and without statin-associated myalgia - A systematic review and meta-analysis of 7 studies with 2420 patients.
Vitamin D (vit D) deficiency may be associated with an increased risk of statin-related symptomatic myalgia in statin-treated patients. The aim of this meta-analysis was to substantiate the role of serum vitamin D levels in statin-associated myalgia. The search included PUBMED, Cochrane Library, Scopus, and EMBASE up to April 1, 2014 to identify studies that investigated the impact of vit D levels in statin-treated subjects with and without myalgia. This meta-analysis provides evidence that low vit D levels are associated with myalgia in patients on statin therapy. Randomized controlled trials are necessary to establish whether vitamin D supplementation reduces the risk for statin-associated myalgia.
 
Statins decrease all-cause mortality only in CKD patients not requiring dialysis therapy—A meta-analysis of 11 randomized controlled trials involving 21,295 participants
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality not only among the general population, but also in patients with chronic kidney disease (CKD). Several clinical trials have demonstrated that inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase (statins) are gaining widespread acceptance as a principal therapy for the primary and secondary prevention of atherosclerosis and CVD.
 
A meta-analysis of the role of statins on renal outcomes in patients with chronic kidney disease. Is the duration of therapy important?
Chronic kidney disease (CKD) is associated with cardiovascular disease (CVD). Beyond established risk factors these patients have additional predictors of CVD such as proteinuria, electrolyte imbalances, inflammation, increased oxidative stress, and endothelial dysfunction that greatly amplify vascular risk. Dyslipidemia is an independent risk factor for the progression of CKD.
 
The effects of statins on blood pressure in normotensive or hypertensive subjects — A meta-analysis of randomized controlled trials
Statins are the lipid lowering treatment of choice for reducing cardiovascular (CV) risk among those with established cardiovascular disease (CVD) or at high risk of incident disease. They inhibit 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase which leads to a decrease in circulating total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) concentrations. Many studies have also investigated the potential role of statins in blood pressure (BP) among patients with hypertension; however, there is still a controversy over whether statin use results in a significant decrease in blood pressure (BP).
 
Effects of statins on lipid profile in chronic kidney disease patients: a meta-analysis of randomized controlled trials
Chronic kidney disease (CKD) is defined as a glomerular filtration rate (GFR)560 mL/min/1.73 m2. The incidence of CKD is rising worldwide, and CKD is associated with increased cardiovascular (CV) morbidity and mortality. CKD with significant albuminuria/proteinuria is frequently associated with substantial alterations of serum lipid levels, most often with elevation in low-density lipoprotein (LDL) particle numbers and triglycerides (TG), and a reduction in high-density lipoprotein cholesterol (HDL-C)2. CKD increases the risk for end stage renal disease (ESRD), atherosclerotic disease, vascular calcification, as well as myocardial infarction, ischemic stroke and death. Even patients in the early stages of CKD are at increased risk of cardiovascular disease (CVD) and a large number of patients with CKD die before developing ESRD.
 
Statins in patients with chronic kidney disease – an attempt at recommendations
Chronic kidney disease (CKD) is associated with cardiovascular disease (CVD) even in the early stages of the disease and a large number of patients die from CVD before developing advanced CKD. Beyond established risk factors (e.g. hypertension, dyslipidaemia, obesity, smoking and diabetes) these patients might also have additional predictors of CVD such as proteinuria, electrolyte imbalances, inflammation, oxidative stress and endothelial dysfunction that amplify vascular risk. Dyslipidaemia is an independent risk factor for the progression of CKD. CKD with significant proteinuria is commonly associated with substantial alteration of serum lipid levels. The most common changes being lowered high density lipoprotein cholesterol (HDL-C) levels and elevated level of triglycerides (TG); hypercholesterolemia per se might be present in around 50% of patients on dialysis.
 
Comparison of the effects of fibrates versus statins on plasma lipoprotein(a) concentrations: a systematic review and meta-analysis of head-to-head randomized controlled trials.
Raised plasma lipoprotein(a) (Lp(a)) concentration is an independent and causal risk factor for atherosclerotic cardiovascular disease. Several types of pharmacological approaches are under evaluation for their potential to reduce plasma Lp(a) levels. There is suggestive evidence that statins and fibrates, two frequently employed lipid-lowering drugs, can lower plasma Lp(a). The present study aims to compare the efficacy of fibrates and statins in reducing plasma concentrations of Lp(a) using a meta-analysis of randomized head-to-head trials.
 
Does coffee consumption alter plasma lipoprotein(a) concentrations? A systematic review.
Coffee consumption alters plasma lipid and cholesterol concentrations, however, its effects on lipoprotein(a) (Lp(a)) have received little study. The aim of this PRISMA compliant systematic review was to examine the role of coffee on serum Lp(a). This study was prospectively registered (PROSPERO 2015:CRD42015032335). PubMed, Scopus, Web of Science and Cochrane Central were searched from inception until 9th January 2016 to detect trials and epidemiological studies investigating the impact of coffee on serum Lp(a) concentrations in humans. We identified six relevant publications describing nine experimental trials of various designs. There were a total of 640 participants across all studies and experimental groups. In short-term controlled studies, consumption of coffee, or coffee diterpenes was associated with either a reduction in serum Lp(a) of ≤11 mg/dL (6 trials, 275 participants), or no effect (2 trials, 56 participants). Conversely, one cross-sectional study with 309 participants showed serum Lp(a) was elevated in chronic consumers of boiled coffee who had a median Lp(a) of 13.0 mg/dL (range 0-130) compared with consumers of filtered coffee who had median Lp(a) 7.9 mg/dL (range 0-144). The effect of coffee on Lp(a) is complex and may follow a biphasic time-course. The type of coffee and the method of preparation appear to be important to determining the effect on Lp(a).
 
Effects of morning vs evening statin administration on lipid profile: A systematic review and meta-analysis.
Evidence about the optimal time of day at which to administer statins is lacking. The objective of this study is to synthesize evidence about effects of morning vs evening statin administration on lipid profile.
We searched PubMed, SCOPUS, Web of Science, and Embase databases (from inception up to July 24, 2016) to identify the relevant studies. Mean differences (MDs) between the change scores in lipid parameters were pooled using a fixed-effect model.
 
Effects of pentoxifylline on inflammatory markers and blood pressure: a systematic review and meta-analysis of randomized controlled trials.
Pentoxifylline is a xanthine derivative with potential cardiovascular benefits. To evaluate the impact of pentoxifylline on blood pressure (BP) and plasma TNF-α, C-reactive protein (CRP) and IL-6 through a systematic review and meta-analysis of randomized controlled trials. The protocol was registered (PROSPERO: CRD42016035988). The search included PUBMED, ProQuest, Scopus and EMBASE until 1 September 2015 to identify trials reporting BP or inflammatory markers during pentoxifylline therapy. Quantitative data synthesis was performed using a random-effects model, with weighted mean difference (WDF) and 95% confidence intervals (CIs) as summary statistics.
 
Efficacy and Safety of Alternate-Day Versus Daily Dosing of Statins: a Systematic Review and Meta-Analysis.
We conducted a meta-analysis of randomized controlled trials (RCTs) and quasi-RCTs to synthesize evidence about the efficacy and safety of alternate-day vs daily dosing of statins. We searched selected databases through January 2, 2017 to identify relevant RCTs and quasi-RCTs. The primary outcome was change in low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglycerides (TG), while secondary outcomes included adverse events and adherence.
 
Hydrophilic vs lipophilic statins in coronary artery disease: A meta-analysis of randomized controlled trials.
Some available experimental studies have reported that hydrophilic statins might have advantages compared with lipophilic statins in patients with coronary artery disease (CAD). Therefore, we performed a meta-analysis of randomized controlled trials (RCTs) investigating the potential differences of lipophilic and hydrophilic statins in patients with CAD. We systematically searched selected electronic databases up to September 2016 to select RCTs, which compared clinical outcomes of hydrophilic vs lipophilic statins. Primary endpoints were cardiovascular (CV) events: major adverse cardiac events, myocardial infarction, cardiac revascularization, stroke, CV death, CV hospitalization, and all-cause mortality. Secondary endpoints were safety parameters: drug discontinuation, statin-associated muscle symptoms and alanine aminotransferase level increase.
 
Impact of statin therapy on plasma adiponectin concentrations: A systematic review and meta-analysis of 43 randomized controlled trial arms.
The effect of statin therapy on plasma adiponectin levels has not been conclusively studied. Therefore, we aimed to evaluate this effect through a systematic review and meta-analysis of available randomized controlled trials (RCTs). Quantitative data synthesis was performed using a random-effects model with weighted mean difference (WMD) and 95% confidence interval (CI) as summary statistics.
 
Lipid-lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel.
In recent years, there has been growing interest in the possible use of nutraceuticals to improve and optimize dyslipidemia control and therapy. Based on the data from available studies, nutraceuticals might help patients obtain theraputic lipid goals and reduce cardiovascular residual risk. Some nutraceuticals have essential lipid-lowering properties confirmed in studies; some might also have possible positive effects on nonlipid cardiovascular risk factors and have been shown to improve early markers of vascular health such as endothelial function and pulse wave velocity. However, the clinical evidence supporting the use of a single lipid-lowering nutraceutical or a combination of them is largely variable and, for many of the nutraceuticals, the evidence is very limited and, therefore, often debatable. The purpose of this position paper is to provide consensus-based recommendations for the optimal use of lipid-lowering nutraceuticals to manage dyslipidemia in patients who are still not on statin therapy, patients who are on statin or combination therapy but have not achieved lipid goals, and patients with statin intolerance. This statement is intended for physicians and other healthcare professionals engaged in the diagnosis and management of patients with lipid disorders, especially in the primary care setting.
 
The effect of statins on cardiovascular outcomes by smoking status: A systematic review and meta-analysis of randomized controlled trials.
Smoking is an important risk factor for cardiovascular disease (CVD) morbidity and mortality. The impact of statin therapy on CVD risk by smoking status has not been fully investigated. Therefore we assessed the impact of statin therapy on CVD outcomes by smoking status through a systematic review of the literature and meta-analysis of available randomized controlled trials (RCTs). The literature search included EMBASE, ProQuest, CINAHL and PUBMED databases to 30 January 2016 to identify RCTs that investigated the effect of statin therapy on cumulative incidence of major CVD endpoints (e.g. non-fatal myocardial infarction, revascularization, unstable angina, and stroke). Relative risks (RR) ratios were calculated from the number of events in different treatment groups for both smokers and non-smokers. Finally 11 trials with 89,604 individuals were included. The number of smokers and non-smokers in the statin groups of the analyzed studies was 8826 and 36,090, respectively. The RR for major CV events was 0.73 (95% confidence interval [CI]: 0.67-0.81; p<0.001) in nonsmokers and 0.72 (95%CI: 0.64-0.81; p<0.001) in smokers. Moderate to high heterogeneity was observed both in non-smokers (I2=77.1%, p<0.001) and in smokers (I2=51.6%, p=0.024) groups. Smokers seemed to benefit slightly more from statins than non-smokers according to the number needed to treat (NNT) analysis (23.5 vs 26.8) based on RRs applied to the control event rates. The number of avoided events per 1000 individuals was 42.5 (95%CI: 28.9-54.6) in smokers and 37.3 (95%CI: 27.2-46.4) in non-smokers. In conclusion, this meta-analysis suggests that the effect of statins on CVD is similar for smokers and non-smokers, but in terms of NNTs and number of avoided events, smokers seem to benefit more although non-significantly.
 
The effects of cinnamon supplementation on blood lipid concentrations: A systematic review and meta-analysis.
Cinnamon is a rich botanical source of polyphenols, whose positive effects on blood lipid concentrations have been hypothesized, but have not been conclusively studied. The objective of the study was to systematically review and evaluate the effect of administration of cinnamon on blood lipid concentrations. We assessed 13 randomized controlled trials with 750 participants investigating the effect of cinnamon supplementation on blood lipid concentrations. A meta-analysis was performed using random effect models, with weighted mean differences (WMDs; with 95% confidence interval [CI]) for endpoints calculated using a random effects model.
 
The Effects of Tamoxifen on Plasma Lipoprotein(a) Concentrations: Systematic Review and Meta-Analysis.
Tamoxifen is a selective estrogen receptor modulator widely used in the treatment of breast cancer. Tamoxifen therapy is associated with lower circulating low-density lipoprotein cholesterol and increased triglycerides, but its effects on other lipids are less well studied. We aimed to investigate the effect of tamoxifen on circulating concentrations of lipoprotein(a) [Lp(a)] through a meta-analysis of available randomized controlled trials (RCTs) and observational studies. This study was registered in the PROSPERO database (CRD42016036890). Scopus, MEDLINE and EMBASE were searched from inception until 22 March 2016 to identify studies investigating the effect of tamoxifen on Lp(a) values in humans. Meta-analysis was performed using an inverse variance-weighted, random-effects model with standardized mean difference (SMD) as the effect size estimate.
 
The impact of argan oil on plasma lipids in humans: Systematic review and meta-analysis of randomized controlled trials.
The study aims to investigate the effect of argan oil on plasma lipid concentrations through a systematic review of the literature and a meta-analysis of available randomized controlled trials. Randomized controlled trials that investigated the impact of at least 2 weeks of supplementation with argan oil on plasma/serum concentrations of at least 1 of the main lipid parameters were eligible for inclusion. Effect size was expressed as the weighted mean difference (WMD) and 95% confidence interval (95% CI). Meta-analysis of data from 5 eligible trials with 292 participants showed a significant reduction in plasma concentrations of total cholesterol (WMD: -16.85 mg/dl, 95% CI [-25.10, -8.60], p < .001), low-density lipoprotein cholesterol (WMD: -11.67 mg/dl, 95% CI [-17.32, -6.01], p < .001), and triglycerides (WMD: -13.69 mg/dl, 95% CI [-25.80, -1.58], p = .027) after supplementation with argan oil compared with control treatment, and plasma concentrations of high-density lipoprotein cholesterol (WMD: 4.14 mg/dl, 95% CI [0.86, 7.41], p = .013) were found to be increased. Argan oil supplementation reduces total cholesterol, low-density lipoprotein cholesterol, and triglycerides and increases high-density lipoprotein cholesterol levels. Additionally, larger clinical trials are needed to assess the impact of argan oil supplementation on other indices of cardiometabolic risk and on the risk of cardiovascular outcomes.
 
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Lipid and Blood Pressure
Meta-analysis Collaboration Group
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90-549 Lodz, Poland
Phone/Fax: +48 42 639 37 71
Email: maciej.banach@umed.lodz.pl
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