Authors: Yoichi Inaba Jennifer A Chen Steven R Bergmann
Publish Date: 2010/03/26
Volume: 26, Issue: 6, Pages: 631-640
Abstract
Electronic databases were searched using a predefined search strategy Data was independently abstracted on study characteristics study quality and outcomes by two reviewers The multivariate relative risks adjusted for confounding factors were calculated from individual studies and then pooled using randomeffects models Statistical heterogeneity was evaluated using I2 statistics Subgroup analyses and metaregression analyses were conducted to assess the robustness of the metaanalysis Publication bias was examined with funnel plot analysis and Egger’s testFour populationbased cohort studies and ten conveniencecohort studies involving 5547 participants were included in the metaanalysis The pooled relative risks of cardiovascular events per 1 increase in brachial FMD adjusted for confounding risk factors was 087 95 CI 083 091 The significant associations between brachial FMD and cardiovascular events were consistent among all subgroups evaluated suggesting the robustness of the metaanalysis However the presence of heterogeneity in study quality the remaining confounding factors and publication bias in the available literature prevent a definitive evaluation of the additional predictive value of brachial FMD beyond traditional cardiovascular risk factorsThe metaanalysis of heterogeneous studies with moderate methodological quality suggested that impairment of brachial FMD is significantly associated with future cardiovascular events Further prospective randomized trials are warranted to confirm the efficacy of the usage of brachial FMD in the management of cardiovascular diseasesThe authors’ responsibilities were as follows—YI selected studies extracted and analyzed the data performed the statistical analyses wrote the manuscript and takes responsibility for data integrity and accuracy of data analysis JAC designed the present study selected studies extracted and analyzed the data and contributed to the writing of the manuscript SRB supervised the present study contributed to the data interpretation and writing of the manuscript All authors agreed on the final version of the manuscript All authors have access to the data and a role in writing the manuscript
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