RESUMEN
The association between smoking and clinical outcomes after coronary stenting is controversial. The aim of this meta-analysis was to assess the association between smoking and in stent restenosis [ISR], major adverse cardiac events [MACE], or major adverse cardiac and cerebrovascular events [MACCE] after coronary stenting. A search for studies published before December 2014 was conducted in PubMed, Embase, and Cochrane library. An inverse random weighted meta-analysis was conducted using logarithm of the odds ratio [OR] and its standard error for each study. Ten studies investigated the association between smoking and ISR. Overall, smoking was not associated with ISR [OR: 1.05, 95% CI: 0.79-1.41; I[2] = 47.8%]. Subgroup analysis also failed to show a significant association between smoking and ISR risk regardless of bare metal stent [BMS] and drug-eluting stent [DES] implantation. Eight studies explored the association between smoking and MACE, but no association was found [OR: 0.92, 95% CI: 0.77-1.10; I[2] = 25.5%], and subgroup analysis revealed that no distinct difference was found between BMS and DES implantation. Three studies investigated the association between smoking and MACCE and significant association was found [OR: 2.09, 95% CI: 1.43-3.06; I[2] = 21.6%].Our results suggest that in patients undergoing percutaneous coronary intervention with stent implantation, smoking is not associated with ISR and MACE; however, smoking is an independent risk factor for MACCE
RESUMEN
PURPOSE: The association between Helicobacter pylori (H. pylori) and blood ammonia levels in cirrhotic patients is controversial. We aimed to clarify this controvercy by performing a meta-analysis of published studies. MATERIALS AND METHODS: We searched PubMed, EMBASE and Cochrane library for studies which explored the association between H. pylori and blood ammonia levels in cirrhotic patients before May 2012. Six cohort studies involved in 632 H. pylori positive and 396 H. pylori negative cirrhotic patients were eligible for our analysis. The summary estimates were presented as standard means differences (SMD) and 95% confidence intervals (CI) from individual studies. RESULTS: Overall, there was significant association between H. pylori infection and the elevated blood ammonia levels in cirrhotic patients (SMD=0.34, 95% CI=0.21-0.47, I2=42.1%). Sensitivity analysis further confirmed this association. Subgroup analysis showed that the association was found only in Asian ethnicity, but not in Caucasian ethnicity. CONCLUSION: H. pylori infection is associated with elevated blood ammonia levels in cirrhotic patients, and more large scale studies and stratify analysis are warranted in order to further evaluate this association.