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The Prevalence of Mitral Valve Prolapse in Panic Disorder: A Meta-Analysis
1The Nathan S. Kline Institute for Psychiatric Research, Clinical Research, NYU Langone Health, Adult Psychiatry, New York, NY.
Background:
Although most studies have suggested that mitral valve prolapse (MVP) is more prevalent in patients with panic disorder (PD) than in healthy controls, there is a substantial uncertainty in the rates of MVP across studies.
Objective:
To investigate, through systematic review and meta-analysis, the relative risk of MVP in patients with PD compared to controls.
Methods:
Embase, Proquest, Pubmed, and Google Scholar electronic databases were searched up to September 2018. All studies published in peer-reviewed journals, which included both PD and controls groups, were selected. Events (presence of MVP) and nonevents (absence of MVP) in PD and control groups were recorded. The main outcome was the measure of relative risk (RR) pooled with 95% confidence intervals, using fixed-effects model. Heterogeneity, small publication effect, and publication bias were evaluated.
Results:
Fourteen studies, including 1146 participants, met eligibility criteria. There was no significant heterogeneity or publication bias. The prevalence of MVP in PD and healthy controls was 27.20% and 9.21%, respectively. Patients with PD had a significantly increased relative risk of MVP compared to controls in the pooled sample (RR = 2.469, 95% confidence interval = 1.848-3.300). Age did not significantly modify the RR.
Conclusions:
MVP is significantly more prevalent in patients with PD than in controls. This meta-analysis of published studies is sufficient to establish an association between PD and MVP; nevertheless, it is not clear that the association is specific to PD. Patients with PD should be evaluated for MVP to decrease possible negative adverse consequences of MVP.
Insights
Patients with panic disorder (PD) have a significantly higher risk of mitral valve prolapse (MVP). This meta-analysis confirms a strong association, suggesting PD patients should be screened for MVP to prevent adverse outcomes.
Area of Science:
- Cardiology
- Psychiatry
- Epidemiology
Background:
- Mitral valve prolapse (MVP) prevalence is debated in panic disorder (PD) patients.
- Existing studies show uncertainty in MVP rates among PD populations.
Purpose of the Study:
- To conduct a systematic review and meta-analysis.
- To determine the relative risk of MVP in PD patients compared to controls.
Main Methods:
- Searched Embase, Proquest, Pubmed, and Google Scholar databases up to September 2018.
- Included 14 peer-reviewed studies with 1146 participants.
- Calculated pooled relative risk (RR) using a fixed-effects model.
Main Results:
- MVP prevalence was 27.20% in PD patients and 9.21% in controls.
- PD patients had a significantly increased relative risk of MVP (RR = 2.469).
- No significant heterogeneity or publication bias was detected.
Conclusions:
- MVP is significantly more prevalent in patients with PD.
- A clear association between PD and MVP is established.
- Recommend screening PD patients for MVP to mitigate potential adverse consequences.
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