ABSTRACT
This meta-analysis aimed to compare the effectiveness of high statin monotherapy and a combination of statin and ezetimibe to prevent cardiovascular outcomes in patients with acute coronary syndrome (ACS). The study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted comprehensive searches across online databases, including MEDLINE/ PubMed, EMBASE, and the Web of Science, to find the relevant articles from the databases' inception to 10 Feb 2024. Outcomes assessed in the meta-analysis included major cardiovascular events (MACE), all-cause mortality, stroke, myocardial infarction, and unplanned revascularization. Data analysis was conducted utilizing RevMan Version 5.3.1. The comparison of outcomes between the two groups involved the calculation of risk ratios (RR) accompanied by 95% confidence intervals (CI) using either a random or fixed-effect model. Five studies were included in this meta-analysis, encompassing 48,668 patients. The pooled analysis showed that the risk of all-cause mortality was higher in patients receiving high statin monotherapy. However, no significant differences in MACE, myocardial infarction, stroke, and revascularization were reported. While acknowledging the limitations, including the lack of randomized controlled trials and the dominance of one study in the analysis, these findings underscore the importance of further research to clarify the comparative effectiveness of these treatment modalities in preventing cardiovascular outcomes in ACS patients.
ABSTRACT
The objective of this study was to compare the impact of amiodarone and lidocaine on survival and neurological outcomes following cardiac arrest. A systematic review of randomized controlled trials (RCTs) as well as cohort and cross-sectional trials was undertaken, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Potential relevant studies were searched in databases, including PubMed, Embase, Cochrane Library, and Web of Science, from the beginning of databases to February 15, 2024. Outcomes assessed in this study were survival to hospital discharge, survival to hospital admission or 24 hours, favorable neurological outcomes, and return of spontaneous circulation (ROSC). A total of seven studies (five observational and two RCTs) were included in this meta-analysis encompassing 19,081 patients with cardiac arrest. Pooled analysis showed no difference between amiodarone and lidocaine in terms of survival to hospital discharge (odds ratio (OR): 0.88, 95% confidence interval (CI): 0.75 to 1.04), ROSC (OR: 0.94, 95% CI: 0.84 to 1.05, p-value: 0.25), favorable neurological outcomes (OR: 0.88, 95% CI: 0.66 to 1.17, p-value: 0.38), and survival to 24 hours (OR: 0.82, 95% CI: 0.55 to 1.21, p-value: 0.31). While lidocaine demonstrated a slight survival advantage, the differences were statistically insignificant. Similarly, no significant variations were observed in ROSC incidence, neurological outcomes, or survival at 24 hours. These findings align with current guidelines but underscore the necessity for further rigorous RCTs to provide conclusive recommendations.
