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20. Effects of muscle strength training combined with aerobic training versus aerobic training alone on cardiovascular disease risk indicators in patients with coronary artery disease: a systematic review and meta-analysis of randomised clinical trials

Author

Terada, Tasuku, Pap, Robert, Thomas, Abby, Wei, Roger, Noda, Takumi, Visintini, Sarah, and Reed, Jennifer L

Abstract

ObjectiveTo compare the effects of aerobic training combined with muscle strength training (hereafter referred to as combined training) to aerobic training alone on cardiovascular disease risk indicators in patients with coronary artery disease (CAD).DesignSystematic review with meta-analysis.Data sourcesMEDLINE, Embase, CINAHL, SPORTDiscus, Scopus, trial registries and grey literature sources were searched in February 2024.Eligibility criteriaRandomised clinical trials comparing the effects of ≥4 weeks of combined training and aerobic training alone on at least one of the following outcomes: cardiorespiratory fitness (CRF), anthropometric and haemodynamic measures and cardiometabolic blood biomarkers in patients with CAD.ResultsOf 13 246 studies screened, 23 were included (N=916). Combined training was more effective in increasing CRF (standard mean difference (SMD) 0.26, 95% CI 0.02 to 0.49, p=0.03) and lean body mass (mean difference (MD) 0.78 kg, 95% CI 0.39 kg to 1.17 kg, p<0.001), and reducing per cent body fat (MD −2.2%, 95% CI −3.5% to −0.9%, p=0.001) compared with aerobic training alone. There were no differences in the cardiometabolic biomarkers between the groups. Our subgroup analyses showed that combined training increases CRF more than aerobic training alone when muscle strength training was added to aerobic training without compromising aerobic training volume (SMD 0.36, 95% CI 0.05 to 0.68, p=0.02).ConclusionCombined training had greater effects on CRF and body composition than aerobic training alone in patients with CAD. To promote an increase in CRF in patients with CAD, muscle strength training should be added to aerobic training without reducing aerobic exercise volume.

Published
2024
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23. Influence of preoperative frailty on quality of life after cardiac surgery: A systematic review and meta‐analysis.

Author

Fehlmann, Christophe A., Bezzina, Kathryn, Mazzola, Rosetta, Visintini, Sarah M., Guo, Ming Hao, Rubens, Fraser D., Wells, George A., McGuinty, Caroline, Huang, Allen, Khoury, Lara, and Boczar, Kevin Emery

Subjects
CARDIAC surgery & psychology, FRAIL elderly, META-analysis, PREOPERATIVE period, SYSTEMATIC reviews, MORTALITY, RESEARCH methodology evaluation, PATIENT-centered care, PATIENT readmissions, DISEASES, QUALITY of life, ODDS ratio
Abstract

Background: Frailty has emerged as an important prognostic marker of increased mortality after cardiac surgery, but its association with quality of life (QoL) and patient‐centered outcomes is not fully understood. We sought to evaluate the association between frailty and such outcomes in older patients undergoing cardiac surgery. Methods: This systematic review included studies evaluating the effect of preoperative frailty on QoL outcomes after cardiac surgery amongst patients 65 years and older. The primary outcome was patient's perceived change in QoL following cardiac surgery. Secondary outcomes included residing in a long‐term care facility for 1 year, readmission in the year following the intervention, and discharge destination. Screening, inclusion, data extraction, and quality assessment were performed independently by two reviewers. Meta‐analyses based on the random‐effects model were conducted. The evidential quality of findings was assessed with the GRADE profiler. Results: After the identification of 3105 studies, 10 observational studies were included (1580 patients) in the analysis. Two studies reported on the change in QoL following cardiac surgery, which was higher for patients with frailty than for patients without. Preoperative frailty was associated with both hospital readmission (pooled odds ratio [OR] 1.48 [0.80–2.74], low GRADE level) as well as non‐home discharge (pooled OR 3.02 [1.57–5.82], moderate GRADE level). Conclusion: While evidence in this field is limited by heterogeneity of frailty assessment and non‐randomized data, we demonstrated that baseline frailty may possibly be associated with improved QoL, but with increased readmission as well as discharge to a non‐home destination following cardiac surgery. These patient‐centered outcomes are important factors when considering interventional options for older patients. Study Registration: OSF registries (https://osf.io/vm2p8). [ABSTRACT FROM AUTHOR]

Published
2023
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24. The efficacy of inspiratory muscle training in patients with coronary artery disease: Protocol for a systematic review and meta-analysis.

Author

Kadoya, Yoshito, Balamane, Saad, Visintini, Sarah, and Chow, Benjamin

Subjects
RESPIRATORY muscles, CORONARY artery disease, RESEARCH protocols, CARDIAC patients, CROSSOVER trials, EXERCISE therapy, MUSCLE strength, RESISTANCE training
Abstract

Background: Inspiratory muscle training (IMT) has been recognized as an effective form of training in patients with cardiovascular disease and heart failure. However, little is known about the efficacy of IMT in the treatment of patients with coronary artery disease (CAD). The aim of this systematic review will be to evaluate randomized controlled studies to understand the effect of IMT on CAD patients. Method: We will include randomized controlled trials evaluating the efficacy of IMT in patients 18 years and older diagnosed with CAD. Crossover trials, cluster-randomized, quasi-randomized, and non-randomized trials will be excluded. Study search will be conducted in major databases (MEDLINE, the Cochrane Central Register of Controlled Trials, Embase, and PEDro). The study intervention will be IMT independent of the duration, frequency, or intensity of training. The primary outcome will be quality of life, patient-reported health status, and all adverse events related to IMT. Secondary outcomes will include exercise capacity and respiratory muscle strength. The risk of bias will be evaluated based on the Cochrane Risk of Bias tool. Screening, data extraction, and quality assessment will be performed by two independent reviewers. If two or more studies are considered to be clinically homogeneous, a meta-analysis based on the random-effects model will be performed. The quality of evidence will be evaluated based on the GRADE approach. Conclusion: This systematic review will improve our understanding of the effects of IMT on CAD patients and potentially establish IMT as an alternative form of exercise training for the treatment of CAD. Trial registration: Study registration. OSF registries (https://osf.io/3ch7m). Date registered: May 10, 2022. Registration DOI: https://doi.org/10.17605/OSF.IO/GVMY7. [ABSTRACT FROM AUTHOR]

Published
2023
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27. Aortic Stenosis Progression

Author

Willner, Nadav, primary, Prosperi-Porta, Graeme, additional, Lau, Lawrence, additional, Nam Fu, Angel Yi, additional, Boczar, Kevin, additional, Poulin, Anthony, additional, Di Santo, Pietro, additional, Unni, Rudy R., additional, Visintini, Sarah, additional, Ronksley, Paul E., additional, Chan, Kwan-Leung, additional, Beauchesne, Luc, additional, Burwash, Ian G., additional, and Messika-Zeitoun, David, additional

Published
2022
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28. Peer-support interventions for women with cardiovascular disease: protocol for synthesising the literature using an evidence map

Author

Parry, Monica, primary, Visintini, Sarah, additional, Johnston, Amy, additional, Colella, Tracey JF, additional, Kapur, Deeksha, additional, Liblik, Kiera, additional, Gomes, Zoya, additional, Dancey, Sonia, additional, Liu, Shuangbo, additional, Goodenough, Catherine, additional, Hay, Jacqueline L, additional, Noble, Meagan, additional, Adreak, Najah, additional, Robert, Helen, additional, Tang, Natasha, additional, O'Hara, Arland, additional, Wong, Anice, additional, and Mullen, Kerri-Anne, additional

Published
2022
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31. Influence of preoperative frailty on quality of life after cardiac surgery: a systematic review and meta-analysis

Author

Fehlmann, Christophe, Bezzina, Kathryn, Guo, Ming, Visintini, Sarah, Rubens, Fraser, Wells, George, Mazzola, Rosetta, McGuinty, Caroline, Huang, Allen, Khoury, Lara, and Boczar, Kevin

Subjects
meta-analysis, quality of life, systematic review, Medicine and Health Sciences, evidence synthesis, frailty, valve replacement, older patients, cardiac surgery, frail
Abstract

Background Frailty has emerged as an important prognostic marker of worse outcomes after cardiac surgery, but evidence regarding its ability to predict quality of life after cardiac surgery is currently lacking. Whether frail patients derive the same quality of life benefit after cardiac surgery as patients without frailty is a matter that still remains unclear. Methods This systematic review will include interventional studies (RCT and others) and observational studies evaluating the effect of preoperative frailty on quality-of-life outcomes after cardiac surgery amongst patients 65 years and older. Studies will be retrieved from major databases including the Cochrane Central Register of Controlled Trials, Embase, and Medline. The primary exposure will be frailty status, independent of the tool used. The primary outcome will be change in quality of life, independent of the tool used. Secondary outcomes include readmission during the year following the index intervention, discharge to a long-term care facility and living in a long-term care facility at one year. Screening, inclusion, data extraction and quality assessment will be performed independently by two reviewers. Meta-analysis based on the random-effects model will be conducted to compare the different outcome between frail and non-frail patients. The evidential quality of the findings will be assessed with the GRADE profiler. Conclusion The findings of this systematic review will be important to clinicians, patients and health policy-makers regarding the use of preoperative frailty as a screening and assessment tool before cardiac surgery.

Published
2022
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32. Peer support interventions for women with cardiovascular disease: An evidence map

Author

Parry, Monica, Johnston, Amy, Colella, Tracey, Visintini, Sarah, Kapur, Deeksha, Liblik, Kiera, Gomes, Zoya, Dancey, Sonia, Liu, Shuangbo, Goodenough, Catherine, Hay, Jacqueline, Adreak, Najah, Robert, Helen, Tang, Natasha, O'Hara, Arland, Wong, Anice, Mullen, Kerri-Anne, and Noble, Meagan

Subjects
Health Communication, Cardiovascular Diseases, Communication, Medicine and Health Sciences, Diseases, Gender, Race, Sexuality, and Ethnicity in Communication, Social and Behavioral Sciences
Abstract

The leading cause of premature death for Canadian women is cardiovascular disease (CVD). CVD in women is complex, it varies across the lifespan and it is influenced by both sex and gender. Our overall goal is to describe the use of peer support interventions for women with CVD (ischemic heart disease, stroke, and heart failure) using an evidence map. We will use the Individual and Family Self-Management Theory and extract data from peer support interventions that relate to context (i.e., age, ethnicity, racism, and gender - identity, roles, relations, institutionalized), process (i.e., one-on-one, group, on-line) and outcomes (i.e., health status, health-related quality of life, healthcare costs).

Published
2022
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34. Inhaled anaesthesia compared with conventional sedation in post cardiac arrest patients undergoing temperature control: A systematic review and meta-analysis

Author

Parlow, Simon, primary, Lepage-Ratte, Melissa Fay, additional, Jung, Richard G., additional, Fernando, Shannon M., additional, Visintini, Sarah, additional, Sterling, Lee H., additional, Di Santo, Pietro, additional, Simard, Trevor, additional, Russo, Juan J., additional, Labinaz, Marino, additional, Hibbert, Benjamin, additional, Nolan, Jerry P., additional, Rochwerg, Bram, additional, and Mathew, Rebecca, additional

Published
2022
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35. Examining anti-inflammatory therapies in the prevention of cardiovascular events: protocol for a systematic review and network meta-analysis of randomised controlled trials

Author

Boczar, Kevin Emery, primary, Shin, Sheojung, additional, Bezzina, Kathryn A, additional, Geejo, Aishwarya, additional, Pearson, Alexander Liam, additional, Shahab, Saba, additional, Fehlmann, Christophe A, additional, Visintini, Sarah, additional, Beanlands, Rob, additional, and Wells, George A, additional

Published
2022
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36. Safety of same-day discharge in patients with left main percutaneous intervention

Author

Abdel-Razek, Omar, primary, Jung, Young, additional, Jung, Richard, additional, Skanes, Stephanie, additional, Dhaliwal, Shan, additional, Stotts, Cameron, additional, Di Santo, Pietro, additional, Goh, Cheng Yee, additional, Verreault-Julien, Louis, additional, Visintini, Sarah, additional, Bradley, Jennifer, additional, Simard, Trevor, additional, Ramirez, F. Daniel, additional, Russo, Juan J., additional, Froeschl, Michael, additional, Labinaz, Marino, additional, and Hibbert, Benjamin, additional

Published
2022
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37. Influence of preoperative frailty on quality of life after cardiac surgery: Protocol for a systematic review and meta-analysis

Author

Bezzina, Kathryn, primary, Fehlmann, Christophe A., additional, Guo, Ming Hao, additional, Visintini, Sarah M., additional, Rubens, Fraser D., additional, Wells, George A., additional, Mazzola, Rosetta, additional, McGuinty, Caroline, additional, Huang, Allen, additional, Khoury, Lara, additional, and Boczar, Kevin Emery, additional

Published
2022
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38. Rhythm Monitoring Strategy and Arrhythmia Recurrence in Atrial Fibrillation Ablation Trials: A Systematic Review

Author

Unni, Rudy R., primary, Prager, Ross T., additional, Odabashian, Roupen, additional, Zhang, Jimmy J., additional, Fat Hing, Nicholas Ng, additional, Nery, Pablo B., additional, Pi, Lebei, additional, Aldawood, Wafa, additional, Sadek, Mouhannad S., additional, Redpath, Calum J., additional, Birnie, David H., additional, Alqarawi, Wael, additional, Zagzoog, Amin, additional, Golian, Mehrdad, additional, Klein, Andres, additional, Ramirez, F. Daniel, additional, Green, Martin S., additional, Chen, Li, additional, Visintini, Sarah, additional, Wells, George A., additional, and Nair, Girish M., additional

Published
2022
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45. Evaluation of plasminogen activator inhibitor-1 as a biomarker of unplanned revascularization and major adverse cardiac events in coronary angiography and percutaneous coronary intervention

Author

Jung, Richard G., primary, Simard, Trevor, additional, Di Santo, Pietro, additional, Dhaliwal, Shan, additional, Sypkes, Caleb, additional, Duchez, Anne-Claire, additional, Moreland, Robert, additional, Taylor, Katlyn, additional, Parlow, Simon, additional, Visintini, Sarah, additional, Labinaz, Alisha, additional, Marbach, Jeffrey, additional, Sarathy, Kiran, additional, Bernick, Jordan, additional, Joseph, Joanne, additional, Boland, Paul, additional, Abdel-Razek, Omar, additional, Harnett, David T., additional, Ramirez, F. Daniel, additional, and Hibbert, Benjamin, additional

Published
2020
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49. Efficacy of milrinone and dobutamine in low cardiac output states: Systematic review and meta-analysis

Author

Mathew, Rebecca, Visintini, Sarah M., Ramirez, F. Daniel, DiSanto, Pietro, Simard, Trevor, Labinaz, Marino, Hibbert, Benjamin M., Mathew, Rebecca, Visintini, Sarah M., Ramirez, F. Daniel, DiSanto, Pietro, Simard, Trevor, Labinaz, Marino, and Hibbert, Benjamin M.

Abstract

Purpose: Patients in cardiac intensive care units (ICU) are admitted with increasingly higher disease acuity and a larger burden of non-cardiac critical illness. Accordingly, positive inotropes are being used with increased frequency and little comparative data to support drug selection. We compared the effectiveness and safety of dobutamine and milrinone in low cardiac output states (LCOS) and/or cardiogenic shock (CS). Methods: We performed a systematic review comparing dobutamine to milrinone on all-cause mortality, length of stay in the ICU (LOS-ICU), length of stay in hospital (LOS-H) and significant arrhythmias in hospitalized patients with LCOS and/or CS. Results: We identified 11 studies that meet eligibility requirements and which were published between 2001 and 2016 and included 23,056 patients. Only one randomized clinical trial was identified, with the remaining studies comprising observational cohort studies. The primary outcome, all-cause mortality, trended towards a benefit with milrinone but did not meet pre-specified significance (OR 1.13, 95% CI 1.00-1.29, p=0.06). While LOS-ICU (mean difference -0.72, 95% CI -1.10- -0.34, p=0.0002) was shorter with dobutamine, there was no difference in LOS-H (mean difference -1.22, 95% CI -4.68 – 2.24, p=0.49). Significant arrhythmias, specifically symptomatic and/or requiring antiarrhythmic therapy, were no different between the groups (OR 1.78, 95% CI 0.85-3.76, p=0.13). Conclusions: Currently available data comparing milrinone to dobutamine in patients requiring inotropic support is limited. Dobutamine may be associated with a shorter LOS in the ICU, with a worrisome signal of increased risk of allcause mortality. Randomized data are needed to guide inotrope selection in patients with LCOS and/or CS.

Published
2019

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