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Fluoroquinolones are associated with increased risk of aortic aneurysm or dissection: systematic review and meta-analysis

2021Journal article Restricted access
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dc.contributor.authorVouga Ribeiro, Nuno
dc.contributor.authorMelo, Ryan
dc.contributor.authorGuerra, Nuno C.
dc.contributor.authorNobre, Ângelo
dc.contributor.authorFernandes, Ricardo M.
dc.contributor.authorPedro, Luís M
dc.contributor.authorCosta, João
dc.contributor.authorPinto, Fausto J.
dc.contributor.authorCaldeira, Daniel
dc.date.accessioned2022-03-25T17:14:19Z
dc.date.available2022-03-25T17:14:19Z
dc.date.issued2021
dc.description© 2020 Elsevier Inc. All rights reservedpt_PT
dc.description.abstractFluoroquinolone use has been associated with collagen disease events, raising safety concerns. We hypothesized that the use of fluoroquinolones is associated with aortic aneurysm (AA) and aortic dissection or aortic rupture (AD/AR). We performed a systematic review with meta-analysis on studies published until March 2019. Seven observational studies were included, comprising 2,851,646 participants. The studies were evaluated regarding their risk of bias. Results on fluoroquinolone use risk comparing with nontreatment and with beta-lactam antibiotic use were extracted. The estimates were pooled through a random-effects model meta-analysis and heterogeneity assessed through the I2 statistic. Sensitivity analysis were performed, grouping studies per design and with exclusion of studies with critical risk of bias. Fluoroquinolone use was associated with a higher risk of AA/AD/AR, comparing with a nontreatment intervention (odds ratio = 2.26; 95%CI 1.93-2.65; I2 = 30%) and comparing with a beta-lactam intervention (odds ratio = 1.56; 95%CI 1.37-1.79; I2 = 0%). This harm effect remained significant when pooling the results for the AD/AR outcome only and across various study designs. Studies comparing with beta-lactam intervention were considered to have a moderate risk of bias, while the remaining ones were classified as having at least a serious risk of bias. All evaluated outcomes had very low Grading of Recommendation, Assessment, Development and Evaluation evidence. Fluoroquinolone use was associated with a significant risk of AA/AD/AR.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationSemin Thorac Cardiovasc Surg. Winter 2021;33(4):907-918pt_PT
dc.identifier.doi10.1053/j.semtcvs.2020.11.011pt_PT
dc.identifier.eissn1532-9488
dc.identifier.issn1043-0679
dc.identifier.urihttp://hdl.handle.net/10451/51993
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/journal/seminars-in-thoracic-and-cardiovascular-surgerypt_PT
dc.subjectAortic aneurysmpt_PT
dc.subjectAortic dissectionpt_PT
dc.subjectFluoroquinolonept_PT
dc.subjectMeta-analysispt_PT
dc.subjectSystematic reviewpt_PT
dc.titleFluoroquinolones are associated with increased risk of aortic aneurysm or dissection: systematic review and meta-analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage918pt_PT
oaire.citation.issue4pt_PT
oaire.citation.startPage907pt_PT
oaire.citation.titleSeminars in Thoracic and Cardiovascular Surgerypt_PT
oaire.citation.volume33pt_PT
person.familyNameVouga Ribeiro
person.familyNameGouveia e Melo
person.familyNameFernandes
person.familyNamePedro
person.familyNamePinto
person.familyNameCaldeira
person.givenNameNuno
person.givenNameRyan
person.givenNameRicardo
person.givenNameLuís
person.givenNameFausto J.
person.givenNameDaniel
person.identifier309018
person.identifier1308889
person.identifier.ciencia-idA012-09CC-78E9
person.identifier.ciencia-id211B-B548-CE4E
person.identifier.ciencia-id0B14-1812-24DC
person.identifier.ciencia-idC311-AEDD-6DBB
person.identifier.ciencia-idAA19-EC35-8D01
person.identifier.orcid0000-0002-8500-5235
person.identifier.orcid0000-0001-8327-6384
person.identifier.orcid0000-0002-7253-6475
person.identifier.orcid0000-0003-4310-9324
person.identifier.orcid0000-0002-8034-4529
person.identifier.orcid0000-0002-2520-5673
person.identifier.ridC-7501-2015
person.identifier.ridG-9363-2015
person.identifier.scopus-author-id57220088914
person.identifier.scopus-author-id24436565500
person.identifier.scopus-author-id7004454630
person.identifier.scopus-author-id7102740158
person.identifier.scopus-author-id36623384200
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
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