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- Cardiovascular events reported in randomized controlled trials in restless legs syndromePublication . Duarte, Gonçalo Silva; Alves, Mariana; Silva, Maria A.; Câmara, Raquel; Caldeira, Daniel; Ferreira, Joaquim J.Objective: Evaluate the frequency of cardiovascular adverse events reported in randomized controlled trials (RCT) in Restless Leg Syndrome (RLS). Methods: Databases were searched up to October 2015. Randomized, double-blind, placebo-controlled trials of patients with RLS were included if quantitative data were extractable. The primary outcome was cardiovascular adverse events defined as cardiac diseases, blood pressure abnormalities, syncope, cerebrovascular diseases, thromboembolic events, and sudden death. The pooled estimated prevalence of cardiovascular (CV) adverse events (AE) and respective 95% confidence interval (CI) was determined by using a meta-analysis. Results: In sum, 28 RCT (2515 participants in the placebo arm and 4223 participants in the intervention arm) reported CV AE. The pooled estimated prevalence of CV AE was 0.61% (95% CI 0.31 to 0.91; I2 ¼ 0%) in the placebo arm and 0.68% (95%CI 0.40 to 0.96; I2 ¼ 18.25%) in the intervention arm. The frequency of major CV events (myocardial infarction, stroke and peripheral artery disease) was 0.49% (95%CI 0.22 to 0.77; I2 ¼ 0%) and 0.33% (95% CI 0.16 to 0.50; I2 ¼ 0%) in the placebo and intervention arm, respectively. Conclusions: The frequency of major cardiovascular events in the RLS trials is not negligible, particularly when considering the young age of these patients.
- Does Parkinson's disease increase the risk of cardiovascular events? A systematic review and meta‐analysisPublication . Alves, Mariana; Caldeira, Daniel; Ferro, José; Ferreira, Joaquim J.Background and purpose: The impact of Parkinson’s disease (PD) on the risk of cardiovascular disease is poorly known. The aim was to systematically review observational studies evaluating the association between PD and cardiovascular events. Methods: MEDLINE through PubMed, the Web of Science and Cochrane Central Register of Controlled Trials with conference proceedings were searched from inception to 4 July 2019. Two reviewers independently selected studies comparing cardiovascular events between Parkinson’s disease and control groups. Ischaemic stroke, myocardial infarction and cardiovascular mortality were the outcomes of interest. Pooled estimates of odds ratios (ORs) and 95% confidence intervals (CIs) were derived by random effects meta-analysis. Heterogeneity was assessed using the I 2 test. The study protocol was registered at PROSPERO: CRD42017076527. Results: Eleven studies were included: nine cohort studies and two case–control studies. PD was associated with a significantly increased risk of stroke (nine studies: OR 1.66, 95% CI 1.19, 2.34; I 2 = 50%). No significant differences were detected regarding myocardial infarction risks (eight studies: OR 1.15, 95% CI 0.72, 1.83; I 2 = 76%) nor cardiovascular mortality risks (seven studies: OR 1.11, 95% CI 0.85, 1.45; I 2 = 47%) in PD patients. Conclusions: The best evidence available showed an association between PD and increased risk of stroke. The risk of myocardial infarction and cardiovascular mortality was not different in PD and non-PD individuals.
- Reminder : cardiovascular patients also benefit from influenza vaccinePublication . Alves, Mariana; Froes, Filipe; Caldeira, DanielThe COVID-19 pandemic has challenged all health care systems worldwide. Nevertheless, it is important to stress that there are other burdensome diseases such as influenza that should also be prevented and managed. Furthermore, the coinfection of COVID-19 and influenza is a matter of concern among healthcare professionals and the general population.