The Effect of Cardiovascular Medications on Disease-Related Outcomes in Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-Analysis

Background: Multiple studies have revealed that idiopathic pulmonary fibrosis (IPF) patients are more at risk for cardiovascular diseases and that many IPF patients receive cardiovascular medications like statins, angiotensin-converting enzyme inhibitor (ACEI), angiotensin receptor blocker (ARB), an...

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Autores principales:	Wan-Tong Zhang, Xu-Jie Wang, Chun-Miao Xue, Xin-Yu Ji, Lin Pan, Wei-Liang Weng, Qiu-Yan Li, Guo-Dong Hua, Bao-Chen Zhu
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	idiopathic pulmonary fibrosis ACEI/ARB statin anticoagulants meta-analysis Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/14a744fe9ea848a88dade8a878fb2cd9
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spelling	oai:doaj.org-article:14a744fe9ea848a88dade8a878fb2cd92021-11-11T10:21:28ZThe Effect of Cardiovascular Medications on Disease-Related Outcomes in Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-Analysis1663-981210.3389/fphar.2021.771804https://doaj.org/article/14a744fe9ea848a88dade8a878fb2cd92021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fphar.2021.771804/fullhttps://doaj.org/toc/1663-9812Background: Multiple studies have revealed that idiopathic pulmonary fibrosis (IPF) patients are more at risk for cardiovascular diseases and that many IPF patients receive cardiovascular medications like statins, angiotensin-converting enzyme inhibitor (ACEI), angiotensin receptor blocker (ARB), and anticoagulants. Existing studies have reported divergent findings on the link between cardiovascular medications and fibrotic disease processes. The aim of this study is to synthesize the evidence on the efficacy of cardiovascular medications in IPF.Methods: We searched studies reporting the effect of cardiovascular medications on IPF in the PubMed, Embase, Web of Science, Cochrane Library, and two Chinese databases (China National Knowledge Infrastructure database and China Wanfang database). We calculated survival data, forced vital capacity (FVC) decline, and IPF-related mortality to assess the efficacy of cardiovascular medications in IPF. We also estimated statistical heterogeneity by using I2 and Cochran Q tests, and publication bias was evaluated by risk of bias tools ROBINS-I.Results: A total of 12 studies were included in the analysis. The included studies had moderate-to-serious risk of bias. Statin use was associated with a reduction in mortality (hazard ratio (HR), 0.89; 95% CI 0.83–0.97). Meta-analysis did not demonstrate any significant relationship between statin use and the FVC decline (HR, 0.86; 95% CI 0.73–1.02), ACEI/ARB use, and survival data (HR, 0.92; 95% CI 0.73–1.15) as well as anticoagulant use and survival data (HR, 1.16; 95% CI 0.62–2.19).Conclusion: Our study suggested that there is a consistent relationship between statin therapy and survival data in IPF population. However, there is currently insufficient evidence to conclude the effect of ACEI, ARB, and anticoagulant therapy on IPF population especially to the disease-related outcomes in IPF.Wan-Tong ZhangXu-Jie WangChun-Miao XueXin-Yu JiLin PanWei-Liang WengWei-Liang WengQiu-Yan LiQiu-Yan LiGuo-Dong HuaBao-Chen ZhuFrontiers Media S.A.articleidiopathic pulmonary fibrosisACEI/ARBstatinanticoagulantsmeta-analysisTherapeutics. PharmacologyRM1-950ENFrontiers in Pharmacology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	idiopathic pulmonary fibrosis ACEI/ARB statin anticoagulants meta-analysis Therapeutics. Pharmacology RM1-950
spellingShingle	idiopathic pulmonary fibrosis ACEI/ARB statin anticoagulants meta-analysis Therapeutics. Pharmacology RM1-950 Wan-Tong Zhang Xu-Jie Wang Chun-Miao Xue Xin-Yu Ji Lin Pan Wei-Liang Weng Wei-Liang Weng Qiu-Yan Li Qiu-Yan Li Guo-Dong Hua Bao-Chen Zhu The Effect of Cardiovascular Medications on Disease-Related Outcomes in Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-Analysis
description	Background: Multiple studies have revealed that idiopathic pulmonary fibrosis (IPF) patients are more at risk for cardiovascular diseases and that many IPF patients receive cardiovascular medications like statins, angiotensin-converting enzyme inhibitor (ACEI), angiotensin receptor blocker (ARB), and anticoagulants. Existing studies have reported divergent findings on the link between cardiovascular medications and fibrotic disease processes. The aim of this study is to synthesize the evidence on the efficacy of cardiovascular medications in IPF.Methods: We searched studies reporting the effect of cardiovascular medications on IPF in the PubMed, Embase, Web of Science, Cochrane Library, and two Chinese databases (China National Knowledge Infrastructure database and China Wanfang database). We calculated survival data, forced vital capacity (FVC) decline, and IPF-related mortality to assess the efficacy of cardiovascular medications in IPF. We also estimated statistical heterogeneity by using I2 and Cochran Q tests, and publication bias was evaluated by risk of bias tools ROBINS-I.Results: A total of 12 studies were included in the analysis. The included studies had moderate-to-serious risk of bias. Statin use was associated with a reduction in mortality (hazard ratio (HR), 0.89; 95% CI 0.83–0.97). Meta-analysis did not demonstrate any significant relationship between statin use and the FVC decline (HR, 0.86; 95% CI 0.73–1.02), ACEI/ARB use, and survival data (HR, 0.92; 95% CI 0.73–1.15) as well as anticoagulant use and survival data (HR, 1.16; 95% CI 0.62–2.19).Conclusion: Our study suggested that there is a consistent relationship between statin therapy and survival data in IPF population. However, there is currently insufficient evidence to conclude the effect of ACEI, ARB, and anticoagulant therapy on IPF population especially to the disease-related outcomes in IPF.
format	article
author	Wan-Tong Zhang Xu-Jie Wang Chun-Miao Xue Xin-Yu Ji Lin Pan Wei-Liang Weng Wei-Liang Weng Qiu-Yan Li Qiu-Yan Li Guo-Dong Hua Bao-Chen Zhu
author_facet	Wan-Tong Zhang Xu-Jie Wang Chun-Miao Xue Xin-Yu Ji Lin Pan Wei-Liang Weng Wei-Liang Weng Qiu-Yan Li Qiu-Yan Li Guo-Dong Hua Bao-Chen Zhu
author_sort	Wan-Tong Zhang
title	The Effect of Cardiovascular Medications on Disease-Related Outcomes in Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-Analysis
title_short	The Effect of Cardiovascular Medications on Disease-Related Outcomes in Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-Analysis
title_full	The Effect of Cardiovascular Medications on Disease-Related Outcomes in Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-Analysis
title_fullStr	The Effect of Cardiovascular Medications on Disease-Related Outcomes in Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-Analysis
title_full_unstemmed	The Effect of Cardiovascular Medications on Disease-Related Outcomes in Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-Analysis
title_sort	effect of cardiovascular medications on disease-related outcomes in idiopathic pulmonary fibrosis: a systematic review and meta-analysis
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/14a744fe9ea848a88dade8a878fb2cd9
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The Effect of Cardiovascular Medications on Disease-Related Outcomes in Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-Analysis

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