Shashank, Singam

Background: Hybrid coronary revascularization (HCR), a combination of percutaneous coronary intervention and coronary artery bypass grafting (CABG), is an emerging treatment for patients with multivessel coronary artery disease (MVCAD). While traditional CABG is considered the standard, HCR may mitigate issues like saphenous vein graft failure. Methods: We systematically searched PubMed, Scopus, Web of Science, and Embase until September 2024, targeting randomized controlled trials (RCTs) that evaluated HCR against CABG in MVCAD patients. The quality of included studies was assessed using the ROB2 tool, and data were analyzed using RevMan 5.4. Four RCTs ( n = 382) involving 382 participants were analyzed using a random-effects model. Risk of bias was assessed using the ROB2 tool. Results: Four RCTs ( n = 382) met inclusion criteria. At 30 days, there were no statistically significant differences between HCR and CABG in all-cause death (risk ratios [RR] = 1.35, P = 0.74), stroke (RR = 0.99, P = 0.99), myocardial infarction (RR = 1.17, P = 0.74), or blood transfusion (RR = 0.70, P = 0.14), with zero heterogeneity ( I 2 = 0%). At 1-year follow-up, pooled analyses showed no significant differences in all-cause death (RR = 1.37, P = 0.62) or myocardial infarction (RR = 1.29, P = 0.56), also with consistent homogeneity ( I 2 = 0%). Conclusion: HCR demonstrates comparable safety and effectiveness to CABG for MVCAD, with similar rates of key outcomes at both 30 days and 1 year. Further research with larger samples and longer follow-up is recommended to confirm these findings.

Background: Functional dyspepsia (FD), a disease of the gastroduodenal tract, is one of the functional gastrointestinal disorders (FGID) characterized by postprandial fullness and epigastric pain not attributed to any underlying organic diseases. Sleep quality refers to individuals’ satisfaction with their overall sleep, including sleep initiation, maintenance, duration, and feeling refreshed upon waking. Despite frequent associations between sleep disorders and FGID, comprehensive data on poor sleep quality (PSQ) in FD patients is lacking. Therefore, this study was conducted to investigate the occurrence of PSQ in patients with PSQ. Methods: PubMed, Scopus, and Web of Science were systematically searched to identify relevant literature. All studies reporting PSQ prevalence in FD patients or sufficient data to calculate it were included. Pooled prevalence was calculated for all studies, and an odds ratio was determined for studies with a healthy control group. Meta-regression and subgroup analyses assessed the moderating effects of different variables. Publication bias was examined using funnel plots and Egger’s test p-value. The work has been reported in line with AMSTAR (Assessing the methodological quality of systematic reviews) Guidelines. Results: To the best of our knowledge, this is the first study that pooled the estimate of prevalence of patients with FD with PSQ. Based on 2138 FD patients, the pooled prevalence of poor sleep quality is 57.2% (95% CI: 37%–75.2%), I 2 = 98.4%. The asymmetric funnel plot and Egger’s test P-value indicated a significant publication bias for the pooled prevalence estimate. FD patients are at higher risk for poor sleep, with an odds ratio of 2.39 (95% CI: 1.86–3.06), I 2 = 1.73%. Conclusion: Poor sleep is highly prevalent among FD patients, who are more susceptible to poor sleep than healthy individuals. The findings of the study should be interpreted with caution owing to the high heterogeneity and the publication bias observed for the pooled prevalence. Future research should standardize diagnostic parameters and investigate other confounding factors like anxiety and depression to achieve more accurate estimates.