Prevalence of Cardiovascular Complications in Malaria: A Systematic Review and Meta-Analysis
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Prevalence of Cardiovascular Complications in Malaria : A Systematic Review and Meta-Analysis. / Holm, Anna Engell; Gomes, Laura C.; Farias Marinho, Claudio Romero; Silvestre, Odilson M.; Vestergaard, Lasse S.; Biering-Sorensen, Tor; Brainin, Philip.
In: American Journal of Tropical Medicine and Hygiene, Vol. 104, No. 5, 2021, p. 1643-1650.Research output: Contribution to journal › Review › Research › peer-review
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TY - JOUR
T1 - Prevalence of Cardiovascular Complications in Malaria
T2 - A Systematic Review and Meta-Analysis
AU - Holm, Anna Engell
AU - Gomes, Laura C.
AU - Farias Marinho, Claudio Romero
AU - Silvestre, Odilson M.
AU - Vestergaard, Lasse S.
AU - Biering-Sorensen, Tor
AU - Brainin, Philip
PY - 2021
Y1 - 2021
N2 - Recent studies have suggested that malaria may affect the cardiovascular system. The aim of this systematic review and meta-analysis was to determine the prevalence of cardiovascular complications in symptomatic malaria patients. We searched databases such as Pubmed, Embase, Cochrane, and Web of Science (January 1950-April 2020) for studies reporting on cardiovascular complications in adults and children with malaria. Cardiovascular complications were defined as abnormalities in electrocardiogram (ECG), cardiac biomarkers, and echocardiography on admission or during outpatient examination. Studies of patients with known heart disease or cardiovascular evaluation performed after the start of intravenous antimalarial medication were excluded. The study was registered in International Prospective Register of Systematic Reviews (PROSPERO) (No.: CRD42020167672). The literature search yielded 1,243 studies, and a total of 43 studies with symptomatic malaria patients were included. Clinical studies (n = 12 adults; n = 5 children) comprised 3,117 patients, of which a majority had Plasmodium falciparum (n = 15) and were diagnosed with severe malaria (n = 13). In random-effects models of adults, the pooled prevalence estimate for any cardiovascular complication was 7% (95% CI: 5-9). No meta-analysis was conducted in children, but the range of abnormal ECG was 0-8%, cardiac biomarkers 0-57%, and echocardiography 4-9%. We analyzed 33 cases (n =10 postmortem), in which the most common cardiovascular pathologies were myocarditis and acute coronary syndrome. All histopathological studies found evidence of parasitized red blood cells in the myocardium. Cardiovascular complications are not uncommon in symptomatic adults and children with malaria. Additional studies investigating malaria and cardiovascular disease are encouraged.
AB - Recent studies have suggested that malaria may affect the cardiovascular system. The aim of this systematic review and meta-analysis was to determine the prevalence of cardiovascular complications in symptomatic malaria patients. We searched databases such as Pubmed, Embase, Cochrane, and Web of Science (January 1950-April 2020) for studies reporting on cardiovascular complications in adults and children with malaria. Cardiovascular complications were defined as abnormalities in electrocardiogram (ECG), cardiac biomarkers, and echocardiography on admission or during outpatient examination. Studies of patients with known heart disease or cardiovascular evaluation performed after the start of intravenous antimalarial medication were excluded. The study was registered in International Prospective Register of Systematic Reviews (PROSPERO) (No.: CRD42020167672). The literature search yielded 1,243 studies, and a total of 43 studies with symptomatic malaria patients were included. Clinical studies (n = 12 adults; n = 5 children) comprised 3,117 patients, of which a majority had Plasmodium falciparum (n = 15) and were diagnosed with severe malaria (n = 13). In random-effects models of adults, the pooled prevalence estimate for any cardiovascular complication was 7% (95% CI: 5-9). No meta-analysis was conducted in children, but the range of abnormal ECG was 0-8%, cardiac biomarkers 0-57%, and echocardiography 4-9%. We analyzed 33 cases (n =10 postmortem), in which the most common cardiovascular pathologies were myocarditis and acute coronary syndrome. All histopathological studies found evidence of parasitized red blood cells in the myocardium. Cardiovascular complications are not uncommon in symptomatic adults and children with malaria. Additional studies investigating malaria and cardiovascular disease are encouraged.
KW - PLASMODIUM-VIVAX MALARIA
KW - FALCIPARUM-MALARIA
KW - PARASITIZED ERYTHROCYTE
KW - CARDIAC INVOLVEMENT
KW - MYOCARDIAL DAMAGE
KW - INFECTION
KW - CHILDREN
KW - ADULTS
KW - CYTOADHERENCE
KW - INFLAMMATION
U2 - 10.4269/ajtmh.20-1414
DO - 10.4269/ajtmh.20-1414
M3 - Review
C2 - 33724926
VL - 104
SP - 1643
EP - 1650
JO - Journal. National Malaria Society
JF - Journal. National Malaria Society
SN - 0002-9637
IS - 5
ER -
ID: 272072291