Comparison of Pharmacological Treatment Effects on Long-Time Outcomes in Heart Failure With Preserved Ejection Fraction: A Network Meta-analysis of Randomized Controlled Trials
Beneficial effects of therapeutic drugs are controversial for heart failure with preserved ejection fraction (HFpEF). This meta-analysis aimed to evaluate and compare the interactive effects of different therapeutic drugs and placebo in patients with HFpEF. A comprehensive search was conducted using...
Guardado en:
| Autores principales: | , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Frontiers Media S.A.
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/7f70d280450e4cc8bb77f29bf2571813 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:7f70d280450e4cc8bb77f29bf2571813 |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:7f70d280450e4cc8bb77f29bf25718132021-11-30T19:18:56ZComparison of Pharmacological Treatment Effects on Long-Time Outcomes in Heart Failure With Preserved Ejection Fraction: A Network Meta-analysis of Randomized Controlled Trials1663-981210.3389/fphar.2021.707777https://doaj.org/article/7f70d280450e4cc8bb77f29bf25718132021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fphar.2021.707777/fullhttps://doaj.org/toc/1663-9812Beneficial effects of therapeutic drugs are controversial for heart failure with preserved ejection fraction (HFpEF). This meta-analysis aimed to evaluate and compare the interactive effects of different therapeutic drugs and placebo in patients with HFpEF. A comprehensive search was conducted using PubMed, Google Scholar, and Cochrane Central Register to identify related articles published before March 2021. The primary outcome was all-cause mortality. Secondary outcomes were cardiovascular mortality, heart failure (HF) hospitalization, and worsening HF events. A total of 14 randomized controlled trials, comprising 19,573 patients (intervention group, n = 9,954; control group, n = 9,619) were included in this network meta-analysis. All-cause mortality, cardiovascular mortality, and worsening HF events among therapeutic drugs and placebo with follow-up of 0.5–4 years were not found to be significantly correlated. The angiotensin receptor neprilysin inhibitor (ARNI) and angiotensin-converting enzyme inhibitor (ACEI) significantly reduced the HF hospitalizations compared with placebo (hazard ratio [HR] 0.73, 95% confidence interval [CI] 0.60–0.87 and HR 0.64, 95% CI 0.43–0.96, respectively), without heterogeneity among studies. The ARNI was superior to angiotensin receptor blocker (ARB) in reducing HF hospitalizations (HR 0.80, 95% CI 0.71–0.91), and vericiguat 10 mg ranked worse than beta-blockers for reducing all-cause mortality in patients with HFpEF (HR 3.76, 95% CI 1.06–13.32). No therapeutic drugs can significantly reduce mortality, but the ARNI or ACEI is associated with the low risk of HF hospitalizations for patients with HFpEF.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42021247034Yaowang LinYaowang LinMeishan WuMeishan WuBihong LiaoBihong LiaoXinli PangXinli PangQiuling ChenQiuling ChenJie YuanJie YuanShaohong DongShaohong DongFrontiers Media S.A.articleheart failure with preserved ejection fractionall-cause mortalitycardiovascular mortalityHF hospitalizationrandomized control trialsTherapeutics. PharmacologyRM1-950ENFrontiers in Pharmacology, Vol 12 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
heart failure with preserved ejection fraction all-cause mortality cardiovascular mortality HF hospitalization randomized control trials Therapeutics. Pharmacology RM1-950 |
| spellingShingle |
heart failure with preserved ejection fraction all-cause mortality cardiovascular mortality HF hospitalization randomized control trials Therapeutics. Pharmacology RM1-950 Yaowang Lin Yaowang Lin Meishan Wu Meishan Wu Bihong Liao Bihong Liao Xinli Pang Xinli Pang Qiuling Chen Qiuling Chen Jie Yuan Jie Yuan Shaohong Dong Shaohong Dong Comparison of Pharmacological Treatment Effects on Long-Time Outcomes in Heart Failure With Preserved Ejection Fraction: A Network Meta-analysis of Randomized Controlled Trials |
| description |
Beneficial effects of therapeutic drugs are controversial for heart failure with preserved ejection fraction (HFpEF). This meta-analysis aimed to evaluate and compare the interactive effects of different therapeutic drugs and placebo in patients with HFpEF. A comprehensive search was conducted using PubMed, Google Scholar, and Cochrane Central Register to identify related articles published before March 2021. The primary outcome was all-cause mortality. Secondary outcomes were cardiovascular mortality, heart failure (HF) hospitalization, and worsening HF events. A total of 14 randomized controlled trials, comprising 19,573 patients (intervention group, n = 9,954; control group, n = 9,619) were included in this network meta-analysis. All-cause mortality, cardiovascular mortality, and worsening HF events among therapeutic drugs and placebo with follow-up of 0.5–4 years were not found to be significantly correlated. The angiotensin receptor neprilysin inhibitor (ARNI) and angiotensin-converting enzyme inhibitor (ACEI) significantly reduced the HF hospitalizations compared with placebo (hazard ratio [HR] 0.73, 95% confidence interval [CI] 0.60–0.87 and HR 0.64, 95% CI 0.43–0.96, respectively), without heterogeneity among studies. The ARNI was superior to angiotensin receptor blocker (ARB) in reducing HF hospitalizations (HR 0.80, 95% CI 0.71–0.91), and vericiguat 10 mg ranked worse than beta-blockers for reducing all-cause mortality in patients with HFpEF (HR 3.76, 95% CI 1.06–13.32). No therapeutic drugs can significantly reduce mortality, but the ARNI or ACEI is associated with the low risk of HF hospitalizations for patients with HFpEF.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42021247034 |
| format |
article |
| author |
Yaowang Lin Yaowang Lin Meishan Wu Meishan Wu Bihong Liao Bihong Liao Xinli Pang Xinli Pang Qiuling Chen Qiuling Chen Jie Yuan Jie Yuan Shaohong Dong Shaohong Dong |
| author_facet |
Yaowang Lin Yaowang Lin Meishan Wu Meishan Wu Bihong Liao Bihong Liao Xinli Pang Xinli Pang Qiuling Chen Qiuling Chen Jie Yuan Jie Yuan Shaohong Dong Shaohong Dong |
| author_sort |
Yaowang Lin |
| title |
Comparison of Pharmacological Treatment Effects on Long-Time Outcomes in Heart Failure With Preserved Ejection Fraction: A Network Meta-analysis of Randomized Controlled Trials |
| title_short |
Comparison of Pharmacological Treatment Effects on Long-Time Outcomes in Heart Failure With Preserved Ejection Fraction: A Network Meta-analysis of Randomized Controlled Trials |
| title_full |
Comparison of Pharmacological Treatment Effects on Long-Time Outcomes in Heart Failure With Preserved Ejection Fraction: A Network Meta-analysis of Randomized Controlled Trials |
| title_fullStr |
Comparison of Pharmacological Treatment Effects on Long-Time Outcomes in Heart Failure With Preserved Ejection Fraction: A Network Meta-analysis of Randomized Controlled Trials |
| title_full_unstemmed |
Comparison of Pharmacological Treatment Effects on Long-Time Outcomes in Heart Failure With Preserved Ejection Fraction: A Network Meta-analysis of Randomized Controlled Trials |
| title_sort |
comparison of pharmacological treatment effects on long-time outcomes in heart failure with preserved ejection fraction: a network meta-analysis of randomized controlled trials |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/7f70d280450e4cc8bb77f29bf2571813 |
| work_keys_str_mv |
AT yaowanglin comparisonofpharmacologicaltreatmenteffectsonlongtimeoutcomesinheartfailurewithpreservedejectionfractionanetworkmetaanalysisofrandomizedcontrolledtrials AT yaowanglin comparisonofpharmacologicaltreatmenteffectsonlongtimeoutcomesinheartfailurewithpreservedejectionfractionanetworkmetaanalysisofrandomizedcontrolledtrials AT meishanwu comparisonofpharmacologicaltreatmenteffectsonlongtimeoutcomesinheartfailurewithpreservedejectionfractionanetworkmetaanalysisofrandomizedcontrolledtrials AT meishanwu comparisonofpharmacologicaltreatmenteffectsonlongtimeoutcomesinheartfailurewithpreservedejectionfractionanetworkmetaanalysisofrandomizedcontrolledtrials AT bihongliao comparisonofpharmacologicaltreatmenteffectsonlongtimeoutcomesinheartfailurewithpreservedejectionfractionanetworkmetaanalysisofrandomizedcontrolledtrials AT bihongliao comparisonofpharmacologicaltreatmenteffectsonlongtimeoutcomesinheartfailurewithpreservedejectionfractionanetworkmetaanalysisofrandomizedcontrolledtrials AT xinlipang comparisonofpharmacologicaltreatmenteffectsonlongtimeoutcomesinheartfailurewithpreservedejectionfractionanetworkmetaanalysisofrandomizedcontrolledtrials AT xinlipang comparisonofpharmacologicaltreatmenteffectsonlongtimeoutcomesinheartfailurewithpreservedejectionfractionanetworkmetaanalysisofrandomizedcontrolledtrials AT qiulingchen comparisonofpharmacologicaltreatmenteffectsonlongtimeoutcomesinheartfailurewithpreservedejectionfractionanetworkmetaanalysisofrandomizedcontrolledtrials AT qiulingchen comparisonofpharmacologicaltreatmenteffectsonlongtimeoutcomesinheartfailurewithpreservedejectionfractionanetworkmetaanalysisofrandomizedcontrolledtrials AT jieyuan comparisonofpharmacologicaltreatmenteffectsonlongtimeoutcomesinheartfailurewithpreservedejectionfractionanetworkmetaanalysisofrandomizedcontrolledtrials AT jieyuan comparisonofpharmacologicaltreatmenteffectsonlongtimeoutcomesinheartfailurewithpreservedejectionfractionanetworkmetaanalysisofrandomizedcontrolledtrials AT shaohongdong comparisonofpharmacologicaltreatmenteffectsonlongtimeoutcomesinheartfailurewithpreservedejectionfractionanetworkmetaanalysisofrandomizedcontrolledtrials AT shaohongdong comparisonofpharmacologicaltreatmenteffectsonlongtimeoutcomesinheartfailurewithpreservedejectionfractionanetworkmetaanalysisofrandomizedcontrolledtrials |
| _version_ |
1718406334630592512 |