Impact of cardiac rehabilitation on erectile dysfunction in cardiovascular patients: a systematic review and meta-analysis.

Background: Cardiovascular diseases (CVDs) and erectile dysfunction (ED) frequently co-occur, significantly affecting the quality of life of individuals. Aim: To assess the impact of cardiac rehabilitation (CR) on ED in patients with CVD through a systematic review and meta-analysis. Methods: This study analyzed randomized controlled trials and other studies comparing CR with usual care for adult males (≥18 years) with any cardiac disease. Literature searches were extensive, and the risk of bias was evaluated by the Cochrane Collaboration tool. Data from 6 studies involving 668 participants were included in the meta-analysis. Outcomes: The primary outcome was the improvement in ED, as measured with the International Index of Erectile Function. Results: A statistically significant improvement in erectile function was observed across 6 studies, with a Morris dppc2 effect size of 0.38 (95% CI, 0.17-0.59). Despite initial high heterogeneity (I 2 = 95.7%), identification and correction for selective outcome reporting bias mitigated this issue. Clinical Translation: CR has a modest but statistically significant impact on improving ED in patients with CVD, indicating its potential positive contribution to the quality of life of this group. Strengths and Limitations: The study's strengths include a comprehensive literature search and a rigorous methodological approach. Limitations involve high heterogeneity among studies and a low level of evidence due to small sample sizes and study quality; however, the source of heterogeneity was identified and mitigated following risk-of-bias assessment. Conclusion: The results suggest that CR has a statistically significant but modest impact on improving ED in patients with CVD. Clinicians should consider the integration of CR into the clinical management of these individuals. This study underscores the potential for CR to contribute positively to the quality of life for patients with CVD by addressing associated ED (PROSPERO: CRD42022374625).

Medication Adherence With Polypill in Cardiovascular Disease and High-Risk Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Involving 7364 Participants.

Considering the worldwide mortality and morbidity of cardiovascular diseases (CVDs), the necessity of using multiple pills due to the chronicity of this condition, and the importance of medication adherence in these patients, we conducted this systematic review and meta-analysis to assess the polypill effect on adherence in patients with established CVD and at high risk. To accomplish this review, we searched various databases to access grey literature and several electronic databases to find randomized controlled trials (RCTs) assessing polypills compared to individual pills from January 2000 to October 2022. The outcomes were primarily medication adherence, secondarily systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C) serum level, and serious adverse events (SAEs). Ultimately, 2820 studies were detected and narrowed to 8 RCTs based on the eligibility criteria. In this study, involving 7364 patients, there was a significant improvement in medication adherence in the polypill group compared to the individual pills group (Risk Ratio [RR] = 1.29; [95%CI: 1.10; 1.50]). Out of secondary outcomes, SBP was significantly decreased (Mean Difference [MD] = -1.72 mmHg; [95%CI: -2.40; 1.03]), but LDL-C serum level (MD = -0.65 mg/dl; [95%CI: -4.47; 3.16]) and SAE (RR = 1.08; [95%CI: f0.98; 1.20]) did not have a notable difference in polypill compared to individual pills.

Incidence, prevalence, and characteristics of heart failure among patients with multiple sclerosis: A systematic review and meta-analysis.

INTRODUCTION: Multiple sclerosis (MS) is the most common neurological autoimmune disease. Although it primarily harms the central nervous system, other organs are liable to be affected by it as well. There is a growing body of evidence suggesting that heart failure should be considered as a potential suspect for cardiac dysfunction and insufficiency among MS patients. As such, we designed this systematic review and meta-analysis to elaborate more on the incidence, prevalence, and characteristics of HF among MS patients. METHODS: We conducted a systematic computerized search using four data banks: PubMed (MEDLINE), Scopus, web of science, and Embase (via Elsevier). The literature search found 930 articles. After eliminating duplicates, 695 articles remained, from which 42 articles were assessed for inclusion eligibility, and eventually 8 full-text articles were included in the final data extraction table. RESULTS: The overall prevalence of heart failure was 1% (95% CI: 0.6%-1.5%), which ranged from 0.6% observed in UK to 1.8% for Taiwan study. The overall incidence of heart failure was also 0.7% (95% CI: 0.4%-1.2%), ranging from 0.2% observed in UK to 1.4% in USA. The pooled odds ratio for the association between heart failure and multiple sclerosis calculated based on 4 studies, using random effect model was 1.29 (95% CI: 0.74-2.26; I2=82.5%), but not significant. CONCLUSION: In conclusion, this study demonstrates that patients with MS are at an elevated risk of developing heart failure compared to the general population, which highlights the importance of regular and thorough checkups in PwMS in an effort to better detect any cardiovascular abnormality, dysfunction, or disease as soon as possible to help improve the prognosis.