ObjectiveTo systematically evaluate the dose-response relationship between coffee consumption and liver cancer risk. MethodsThe PubMed, Web of Science, Cochrane Library, EMbase, CNKI, VIP, WanFang Data, and CBM databases were searched from inception to December 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 17.0 software. ResultsFifteen studies (11 cohort studies and 4 case-control studies) involving 557 259 participants were included. The results of meta-analysis showed that coffee consumption was significantly negatively associated with the risk of liver cancer (RR=0.39, 95%CI 0.27 to 0.57, P<0.01). The dose-response meta-analysis showed a non-linear dose-response relationship between coffee consumption and the risk of liver cancer (P<0.01). Compared with people who did not drink coffee, people who drank 1 cup of coffee a day had a 25% lower risk of liver cancer (RR=0.75, 95%CI 0.67 to 0.83), and people who drank 2 cups of coffee a day had a 38% lower risk of liver cancer (RR=0.62, 95%CI 0.56 to 0.70). The risk of liver cancer decreased by 45% (RR=0.55, 95%CI 0.48 to 0.62) for 3 cups of coffee and by 51% (RR=0.49, 95%CI 0.43 to 0.56) for 4 cups of coffee. ConclusionCurrent evidence suggests that there is a nonlinear dose-response relationship between coffee consumption and the risk of liver cancer. These results indicate that habitual coffee consumption is a protective factor for liver cancer. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo investigate the sex-specific impact of baseline myocardial injury on cardiac reverse remodeling after transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis (AS). MethodsThis retrospective cohort study consecutively enrolled patients with symptomatic severe AS who underwent TAVR between May 2021 and January 2024 at the Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University. According to the "Fourth Universal Definition of Myocardial Infarction (2018)", patients were classified into preprocedural myocardial injury-positive [hs-cTnI(+)] and -negative [hs-cTnI(?)] groups based on high-sensitivity cardiac troponin I (hs-cTnI) levels. Echocardiographic parameters were collected at baseline and at 1, 6, and 12 months after TAVR. Left ventricular mass index (LVMi) was used to evaluate the degree of cardiac reverse remodeling. Stratified by sex, the trends of LVMi at each postoperative timepoint were compared between sexes, and the impact of baseline myocardial injury on cardiac reverse remodeling within 12 months after TAVR was analyzed. ResultsA total of 408 patients were enrolled, with a median age of 72 (67, 77) years, including 227 (55.6%) males and 181 (44.4%) females. Preprocedural severe cardiac remodeling was observed in 81 patients, including 48 (21.1%, 48/227) male and 33 (18.2%, 33/181) female patients. Cardiac reverse remodeling in male patients occurred predominantly within the first 6 months after TAVR and subsequently plateaued between 6 and 12 months (P=0.528), whereas female patients showed continuous improvement in LVMi at each follow-up timepoint throughout the 12-month follow-up (P<0.05). There were 118 (52.0%) male and 100 (55.2%) female patients in the hs-cTnI (+) group. In both male and female subgroups, LVMi in the hs-cTnI (+) group was significantly higher than that in the hs-cTnI (?) group at baseline and each follow-up timepoint (P<0.05). ConclusionThe impact of baseline myocardial injury on post-TAVR cardiac reverse remodeling exhibits sex differences. Male patients in the hs-cTnI (+) group show poorer improvement in cardiac reverse remodeling, with a plateau phase at 6 months postoperatively, while female patients demonstrate sustained improvement in reverse remodeling within 12 months after TAVR.
