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Allopurinol and cardiovascular diseases: systematic review and Meta-Analysis - Dissertation Example

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Search Criteria The research that was carried out considered different available sources of information. Available medical databases were taken into consideration. Literature was obtained from Ovid MEDLINE, dating as far back as 1948 to as recent as the fourth week of June 2013…
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Allopurinol and cardiovascular diseases: systematic review and Meta-Analysis
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Download file to see previous pages Key search terms that were used include, allopurinol, uric acid, cardiovascular, xantihine oxidase, myocardial infarction, stroke, vascular, oxypurinol, blood pressure and hypertension. Before full article evaluations, abstract considerations were highly important in determining the suitability of articles used in the study process, under the criteria deemed as suitable for inclusion and their results were not considered for the purposes of independence of research. Study Selection In this paper, we included all studies assessed effects of either allopurinol or oxypurinolin humans that reported data on cardiovascular event rates. A cardiovascular event was defined as follows: (1) angina pectoris, (2) MI, (3) CHF, or (4) stroke (hemorrhagic and ischemic). In addition, We considered identify all studies according to some criteria such as (1) published in English, (2) age above 40 years,(3) meta-analyses, (4) observational studies with control groups, (5) prospective studies or randomized active or placebo controlled trials, (6) parallel or cross-over study design. Based on these criteria, two crossovers RCT one parallel RCT, one randomized, double-blinded, placebo-controlled trial, two observational studies, one study population and one retrospective cohort study. Quality assessment on the basis of Jadad Score shows ranges of scores and their qualities as shown in Figure 1. Data Extraction and Quality By use of the Jadad Score it was imperative to also consider methodological quality in each trial because it lays a foundation for randomization, withdrawals and blinding. Studies without these aspects were rated and given a score of zero. In cases where two or more authors were involved in a research, consensus was important in consolidation. Out of the identified 1421 articles searched in the EMBASE and MEDLINE databases, by use of specific search items. Lastly, a number of articles were given consideration. Statistical analysis Descriptive reporting deems suitable in this review since consideration of articles was the main foundation of the study. Meta-analysis requires that consideration of material ensure that studies have a control group in addition to randomization. Quantitative analysis was carried out in attempting to analyze the data collected. Results Out of the 1421 articles that were searched within the database, identification about 5suitable articles, according to our inclusion and exclusion criteria were made. Figure 1 illustrates details of study selection. Although the studies were not uniform in undertaking and thus employed diversity, it was highly significant to consider various aspects of differentiation. These included population of patients done earlier, the resultant outcomes of the drugs administered and the drugs used. The papers were diverse in design, included drug used, duration, outcomes measured, and patient sample size as shown in Table 1. Figure 1 Study Population Design Intervention Endpoints and results Terawaki 2012 CVD (n= 178) (n= 67) + allopurinol Study population Ischemic heart disease, CHF, stroke and all-cause death Allopurinol 600 mg Duration not specified Allopurinol effects on cardiovascular disease (ischemic heart disease, CHF, and stroke) and all-cause death (HR = 0.342, p = 0.0434, standard error = 0.53058) Nasr 2012 CHF (n= 59) Observational study HF Allopurinol 300mg 36 weeks Comprising global left cardiac function as well as heart failure morbidity and mortality. P = 0.001(Tei index mean 0.47 SD3.8 for ...Download file to see next pages Read More
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