Assessing the Risk of Progression From  Asymptomatic Left XXXX to Overt @entity712 : A Systematic Overview and Meta-Analysis.

@entity1 @entity712 @entity299 @entity67 @entity1002
OBJECTIVES: This study sought to provide estimates of the risk of progression to overt @entity712 ( @entity712 ) from systolic or diastolic asymptomatic @entity1002 through a systematic review and meta-analysis. BACKGROUND: Precise population-based estimates on the progression from asymptomatic @entity1002 (or stage B @entity712 ) to clinical @entity712 (stage C @entity712 ) remain limited, despite its prognostic and clinical implications. Pre-emptive intervention with neurohormonal modulation may attenuate disease progression. METHODS: MEDLINE and EMBASE were systematically searched (until March 2015). Cohort studies reporting on the progression from @entity1002 ( @entity1002 ) or @entity1002 ( @entity1002 ) to overt @entity712 were included. Effect estimates (prevalence, incidence, and relative risk) were pooled using a random-effects model meta-analysis, separately for @entity299 , with heterogeneity assessed with the I(2) statistic. RESULTS: Thirteen reports based on 11 distinct studies of progression of @entity1002 were included in the meta-analysis assessing a total of 25,369 @entity1 followed for 7.9 years on average. The absolute risks of progression to @entity712 were 8.4 per 100 @entity1 -years (95% confidence interval [CI]: 4.0 to 12.8 per 100 @entity1 -years) for those with @entity1002 , 2.8 per 100 @entity1 -years (95% CI: 1.9 to 3.7 per 100 @entity1 -years) for those with @entity1002 , and 1.04 per 100 @entity1 -years (95% CI: 0.0 to 2.2 per 100 @entity1 -years) without any @entity67 evident. The combined maximally adjusted relative risk of @entity712 for @entity1002 was 4.6 (95% CI: 2.2 to 9.8), and that of @entity1002 was 1.7 (95% CI: 1.3 to 2.2). CONCLUSIONS: @entity1002 and @entity1002 are each associated with a substantial risk for incident @entity712 indicating an imperative to develop effective intervention at these stages.
