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      The Efficacy of Beta-Blockers in Patients With Long QT Syndrome 1–3 According to Individuals’ Gender, Age, and QTc Intervals: A Network Meta-analysis

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          Abstract

          Long QT syndrome (LQTS) is an arrhythmic heart disease caused by congenital genetic mutations, and results in increased occurrence rates of polymorphic ventricular tachyarrhythmias and sudden cardiac death (SCD). Clinical evidence from numerous previous studies suggested that beta blockers (BBs), including atenolol, propranolol, metoprolol, and nadolol, exhibit different efficacies for reducing the risk of cardiac events (CEs), such as syncope, arrest cardiac arrest (ACA), and SCD, in patients with LQTS. In this study, we identified relevant studies in MEDLINE, PubMed, embase, and Cochrane databases and performed a meta-analysis to assess the relationship between the rate of CEs and LQTS individuals with confounding variables, including different gender, age, and QTc intervals. Moreover, a network meta-analysis was not only established to evaluate the effectiveness of different BBs, but also to provide the ranked efficacies of BBs treatment for preventing the recurrence of CEs in LQT1 and LQT2 patients. In conclusion, nadolol was recommended as a relatively effective strategy for LQT2 in order to improve the prognosis of patients during a long follow-up period.

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          Most cited references36

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          Graphical methods and numerical summaries for presenting results from multiple-treatment meta-analysis: an overview and tutorial.

          To present some simple graphical and quantitative ways to assist interpretation and improve presentation of results from multiple-treatment meta-analysis (MTM). We reanalyze a published network of trials comparing various antiplatelet interventions regarding the incidence of serious vascular events using Bayesian approaches for random effects MTM, and we explore the advantages and drawbacks of various traditional and new forms of quantitative displays and graphical presentations of results. We present the results under various forms, conventionally based on the mean of the distribution of the effect sizes; based on predictions; based on ranking probabilities; and finally, based on probabilities to be within an acceptable range from a reference. We show how to obtain and present results on ranking of all treatments and how to appraise the overall ranks. Bayesian methodology offers a multitude of ways to present results from MTM models, as it enables a natural and easy estimation of all measures based on probabilities, ranks, or predictions. Copyright © 2011 Elsevier Inc. All rights reserved.
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            Network meta-analysis for indirect treatment comparisons.

            I present methods for assessing the relative effectiveness of two treatments when they have not been compared directly in a randomized trial but have each been compared to other treatments. These network meta-analysis techniques allow estimation of both heterogeneity in the effect of any given treatment and inconsistency ('incoherence') in the evidence from different pairs of treatments. A simple estimation procedure using linear mixed models is given and used in a meta-analysis of treatments for acute myocardial infarction. Copyright 2002 John Wiley & Sons, Ltd.
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              Long-QT syndrome: from genetics to management.

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                Author and article information

                Contributors
                Journal
                Front Pharmacol
                Front Pharmacol
                Front. Pharmacol.
                Frontiers in Pharmacology
                Frontiers Media S.A.
                1663-9812
                14 December 2020
                2020
                : 11
                : 579525
                Affiliations
                Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
                Author notes

                Edited by: Joshua Thomas Butcher, Oklahoma State University, United States

                Reviewed by: Cees Korstanje, Consultant, Nieuw-Vennep, Netherlands

                Thiago Bruder Do Nascimento, University of Pittsburgh, United States

                *Correspondence: Juxiang Li, ljx912@ 123456126.com

                This article was submitted to Cardiovascular and Smooth Muscle Pharmacology, a section of the journal Frontiers in Pharmacology

                Article
                579525
                10.3389/fphar.2020.579525
                7768040
                33381033
                a0c144e3-938e-4d1c-961a-65538da30ba2
                Copyright © 2020 Han, Liu, Li, Qing, Zhai, Xia and Li

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 02 July 2020
                : 13 November 2020
                Page count
                Pages: 0
                Categories
                Review
                Review

                Pharmacology & Pharmaceutical medicine
                beta-blockers,atenolol,propranolol,metoprolol,nadolol,cardiac events

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