Statins in adult patients with HIV Protocol for a systematic review and network meta-analysis
Medicine (Baltimore)
; 97(15): 0116, Apr. 2018. graf, tab
Article
in English
| Sec. Est. Saúde SP, CONASS, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1223347
Responsible library:
BR79.1
ABSTRACT
BACKGROUND:
Patients with HIV have been found to suffer from lipid abnormalities, including elevated levels of total and LDL cholesterol as well as triglyceride levels. Abnormal lipid levels are associated with an increased risk of developing cardiovascular diseases, which are significant causes of mortality among the general population. Therefore, the objective of the current study is to conduct a systematic review with network meta-analysis to compare the effects of statins classes on HIV patients.METHODS:
Randomized clinical trials (RCTs) and observational studies published in English up to 31 December 2017, and which include direct and/or indirect evidence, will be included. Studies will be retrieved by searching four electronic databases and cross referencing. Dual selection and abstraction of data will occur. The primary outcome will all-cause mortality, new event of acute myocardial infarction, stroke (hemorrhagic and ischemic), hospitalization for acute coronary syndrome and urgent revascularization procedures and cardiovascular mortality. Secondary outcomes will be assessment of the differences in change of total cholesterol (TC), low-density lipoprotein (LDL-C), apolipoprotein B (ApoB), high density lipoprotein (HDL-C). Risk of bias will be assessed using the Cochrane Risk of Bias assessment instrument for RCTs and the Strengthening the Reporting of Observational Studies in Epidemiology instrument for observational studies. Network meta-analysis will be performed using multivariate random-effects meta-regression models. The surface under the cumulative ranking curve will be used to provide a hierarchy of statins that reduce cardiovascular mortality in HIV patients. A revised version of the Cochrane Risk of Bias tool (RoB 2.0) will be used to assess the risk of bias in eligible RCTs. Results will be synthesized and analyzed using network meta-analysis (NMA). Overall strength of the evidence and publication bias will be evaluated. Subgroup and sensitivity analysis will also be performed. RESULTS ANDCONCLUSION:
Ethics approval was not required for this study because it was based on published studies. The results and findings of this study will be submitted and published in a scientific peer-reviewed journal. The evidence will determine which combination of interventions are most promising for current practice and further investigation.
Full text:
Available
Collection:
National databases
/
Brazil
Health context:
SDG3 - Target 3.3 End transmission of communicable diseases
/
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
AIDS
/
Cardiovascular Disease
Database:
CONASS
/
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Main subject:
Cardiovascular Diseases
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Cholesterol
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HIV
/
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Type of study:
Controlled clinical trial
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Observational study
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Prognostic study
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Systematic review
Aspects:
Ethical aspects
Language:
English
Journal:
Medicine (Baltimore)
Year:
2018
Document type:
Article
Institution/Affiliation country:
Dante Pazzanese Institute of Cardiology/BR
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Dante Pazzanese Institute of Cardiology, Department of Clinical Research/BR
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Department of AngioCardioNeurology, IRCCS Neuromed/IT
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Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome/IT
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Department of Specialized and General Surgery, Fluminense Federal University/BR
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FOP Unicamp, Department of Clinical Research, Division of Cardiology, Duke University Medical Center/GB
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Faculty of Medicine ABC, Department of Cardiology Santo André/BR
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Faculty of Medicine ABC, Department of Cardiology Santo André, - D Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Department of Cardiology/IR
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Faculty of Medicine ABC, Department of Cardiology/BR
/
Federal University of Mato Grosso, Department of Medicine/BR