Rujirachun Pongprueth, Wattanachayakul Phuuwadith, Winijkul Arjbordin, Ungprasert Patompong
Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand.
Division of Cardiology Department of Medicine Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand.
J Arrhythm. 2019 May 14;35(3):499-505. doi: 10.1002/joa3.12187. eCollection 2019 Jun.
Paroxysmal supraventricular tachycardia (PSVT) has been traditionally considered as a benign rhythm disorder. However, recent studies have suggested that patients with PSVT may have a higher risk of ischemic stroke although the data are limited and inconclusive. The current systematic review and meta-analysis was conducted with the aims to identify all available studies and summarize their results together to better characterize the risk of ischemic stroke among patients with PSVT.
A comprehensive literature review was conducted by searching for published articles indexed in MEDLINE and EMBASE databases from inception through November 11, 2018 to identify all observational studies that compared the risk of ischemic stroke between patients with PSVT and individuals without PSVT. Pooled risk ratio (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method of DerSimonian and Laird.
A total 5 studies (4 cohort studies and 1 case-control study) with 4 886 977 participants met the eligibility criteria and were included into the meta-analysis. The risk of ischemic stroke among patients with PSVT was significantly higher than individuals without PSVT with the pooled RR of 2.03 (95% CI, 1.22-3.38, = 89%).
This study found that PSVT is associated with a higher risk of ischemic stroke. Whether this association is causal and how it should be addressed in clinical practice require further investigations.
阵发性室上性心动过速(PSVT)传统上被认为是一种良性心律失常。然而,最近的研究表明,PSVT患者可能有更高的缺血性中风风险,尽管数据有限且尚无定论。进行本次系统评价和荟萃分析的目的是识别所有可用研究并汇总其结果,以更好地描述PSVT患者缺血性中风的风险。
通过检索MEDLINE和EMBASE数据库中从创刊至2018年11月11日收录的已发表文章进行全面的文献综述,以识别所有比较PSVT患者和非PSVT个体缺血性中风风险的观察性研究。采用DerSimonian和Laird的随机效应、通用逆方差方法计算合并风险比(RR)和95%置信区间(CI)。
共有5项研究(4项队列研究和1项病例对照研究),涉及4886977名参与者符合纳入标准并被纳入荟萃分析。PSVT患者缺血性中风的风险显著高于非PSVT个体,合并RR为2.03(95%CI,1.22 - 3.38,P = 89%)。
本研究发现PSVT与更高的缺血性中风风险相关。这种关联是否具有因果关系以及在临床实践中应如何处理需要进一步研究。