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Association between Thrombomodulin Polymorphisms and Coronary Artery Disease Risk: A Meta-Analysis

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      Abstract

      BackgroundThe associations between the thrombomodulin (TM) polymorphisms and coronary artery disease (CAD) risk remain controversial. The aim of this study was to evaluate the association of TM polymorphisms with CAD susceptibility using a meta-analysis approach.Material/MethodsAll eligible studies were identified through a search of PubMed, EMBASE, and China National Knowledge Infrastructure (CNKI) before February 2014. The associations between the TM polymorphisms and CAD risk was assessed by odds ratios (ORs) and 95% confidence intervals (CIs).ResultsA total of 14 case-control studies, including 5493 cases and 8297 controls, were eventually collected. There was a significant association between TM -33G/A polymorphism and CAD risk (OR=1.61; 95% CI, 1.35–1.92; I2=15%). The TM Ala455Val polymorphism was also associated with a significantly increased CAD risk (OR=1.14; 95% CI, 1.05–1.24; I2=0%). These results remained statistically significant when the adjusted ORs were combined.ConclusionsOur results suggest that TM-33G/A and Ala455Val polymorphisms are risk factors for CAD.

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      Most cited references 22

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      Funnel plots (plots of effect estimates against sample size) may be useful to detect bias in meta-analyses that were later contradicted by large trials. We examined whether a simple test of asymmetry of funnel plots predicts discordance of results when meta-analyses are compared to large trials, and we assessed the prevalence of bias in published meta-analyses. Medline search to identify pairs consisting of a meta-analysis and a single large trial (concordance of results was assumed if effects were in the same direction and the meta-analytic estimate was within 30% of the trial); analysis of funnel plots from 37 meta-analyses identified from a hand search of four leading general medicine journals 1993-6 and 38 meta-analyses from the second 1996 issue of the Cochrane Database of Systematic Reviews. Degree of funnel plot asymmetry as measured by the intercept from regression of standard normal deviates against precision. In the eight pairs of meta-analysis and large trial that were identified (five from cardiovascular medicine, one from diabetic medicine, one from geriatric medicine, one from perinatal medicine) there were four concordant and four discordant pairs. In all cases discordance was due to meta-analyses showing larger effects. Funnel plot asymmetry was present in three out of four discordant pairs but in none of concordant pairs. In 14 (38%) journal meta-analyses and 5 (13%) Cochrane reviews, funnel plot asymmetry indicated that there was bias. A simple analysis of funnel plots provides a useful test for the likely presence of bias in meta-analyses, but as the capacity to detect bias will be limited when meta-analyses are based on a limited number of small trials the results from such analyses should be treated with considerable caution.
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            Author and article information

            Affiliations
            Emergency Center, Ji’nan Sixth People’s Hospital, Zhangqiu, Shandong Province, China
            Author notes
            Corresponding Author: Siliang Zheng, e-mail: zhengsl0531@ 123456163.com
            [A]

            Study Design

            [B]

            Data Collection

            [C]

            Statistical Analysis

            [D]

            Data Interpretation

            [E]

            Manuscript Preparation

            [F]

            Literature Search

            [G]

            Funds Collection

            [*]

            These authors contributed equally to this work

            Journal
            Med Sci Monit
            Med. Sci. Monit
            Medical Science Monitor
            Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
            International Scientific Literature, Inc.
            1234-1010
            1643-3750
            2014
            10 August 2014
            : 20
            : 1407-1414
            25108690
            4138070
            10.12659/MSM.890717
            890717
            © Med Sci Monit, 2014

            This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License

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