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Statistical heterogeneity across trials was assessed using the Cochrans Q test (with p 50% for significant heterogeneity)

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1 Introduction Cardiovascular disease (CVD) is the leading cause of mortality worldwide, accounting for nearly one-third of global deaths each year ( The appeal of these agents stems from their capacity to modulate key pathophysiological contributors in atherosclerosis and heart failure, including oxidative stress, chronic vascular inflammation, endothelial dysfunction, dyslipidemia, and mitochondrial energy deficits ( However, the field is marked by heterogeneous and sometimes contradictory evidence