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Aortic valve calcification and risk of stroke: A systematic review and meta-analysis
Danfeng Zhang1, Xianliang Dai2, Chaoqun Wang3
1Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
Insights
Aortic valve calcification (AVC) is linked to increased stroke risk in older adults. However, current evidence is inconsistent, necessitating further large-scale studies to confirm this association.
Area of Science:
- Cardiovascular Medicine
- Epidemiology
- Geriatrics
Background:
- Aortic valve calcification (AVC) is prevalent in the elderly.
- AVC is suspected to increase stroke risk, but existing research yields conflicting results.
Purpose of the Study:
- To conduct a meta-analysis clarifying the association between AVC and stroke risk.
- To synthesize findings from existing cohort studies.
Main Methods:
- A systematic literature search was performed in Embase, PubMed, and Cochrane Library for cohort studies.
- Data from 7 cohort studies involving 21,395 participants and 1025 strokes were analyzed.
- Risk ratios (RR) and 95% confidence intervals (CIs) were used, with a random-effects model for synthesis.
Main Results:
- A statistically significant correlation between AVC and stroke was found (RR, 1.20; 95% CI, 1.02-1.40).
- Low heterogeneity was observed (I² = 6.9%, P = 0.375).
- Significant results were only apparent in the subgroup with adjusted variables (P = 0.04).
Conclusions:
- The current data do not definitively establish a causal relationship between AVC and stroke risk.
- Larger prospective studies are required to validate the AVC-stroke association.
Abstract:
Aortic valve calcification (AVC) is common among aged population and reported to be associated with the risk of stroke. However, the conclusions are inconsistent among studies. We performed a rigorous meta-analysis to unravel the AVC-stroke relationship. Embase, PubMed and Cochrane library were retrieved for related cohort studies investigating the correlations between AVC and risk of stroke. The language was limited to English. We selected risk ratio (RR) and 95% confidence intervals (CIs) as the effect size. Random-effects model was used in the data synthesis. A total of 7 cohort studies were identified in our meta-analysis with 21,395 participants and 1025 strokes. We detected statistically significant correlation between AVC and stroke (RR, 1.20; 95% CI, 1.02-1.40, P = 0.02) with low heterogeneity (I2 = 6.9%, P = 0.375). Statistically significant results were detected only in the subgroup of "+" degree of adjustment (P = 0.04). Therefore, a definite relationship between AVC and risk of stroke couldn't be decided based on current available data, and more large scale prospective studies were needed to verify the AVC-stroke relationship.
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