Systematic review and meta-analysis on pulmonary hypertension in patients with combined fibrosis and emphysema syndrome

Abstract

Objective \nTo evaluate systematically the incidence and the level of pulmonary hypertension in the patients with combined pulmonary fibrosis with emphysema (CPFE) syndrome compared with those of the patients with idiopathic pulmonary fibrosis (IPF) or pulmonary emphysema/chronic obstructive pulmonary disease (COPD). \n \n \nMethods \nAll the reports about CPFE syndromes were collected by searching these databases including CBM, CNKI, Wan Fang Data, VIP, PubMed, Embase and the Cochrane library (12th in 2017) from January 2005 to January 2018. All the titles/abstracts were reviewed to identify the possible studies with predefined selection criteria. All the data were combined and analyzed using Review Manager 5.3 or Stata 14.0. \n \n \nResults \nA total of 1 385 patients included in 13 reports were selected for this meta-analysis. Compared with the IPF group, the CPFE group had a higher incidence [OR=1.93, 95%CI (1.17, 3.17), P=0.010] and a higher level [MD=11.89, 95%CI (7.39, 16.39), P<0.00001] of pulmonary hypertension. Meanwhile, the incidence [OR=2.62, 95%CI (1.42, 4.81), P=0.002] and the level [MD=7.49, 95%CI (5.27, 9.72), P<0.00001] of pulmonary hypertension also presented higher results compared with the pulmonary emphysema/COPD group. \n \n \nConclusion \nCPFE syndrome manifests a higher incidence and a higher level of pulmonary hypertension when compared with the IPF group as well as the pulmonary emphysema/COPD group and should be monitored regularly. \n \n \nKey words: \nFibrosis;\xa0Pulmonary Emphysema;\xa0Pulmonary hypertension;\xa0Meta-analysis;\xa0Systematic review