دورية أكاديمية
أعرض في EDS

Postponement of Death by Pharmacological Heart Failure Treatment: A Meta-Analysis of Randomized Clinical Trials.

التفاصيل البيبلوغرافية
العنوان: Postponement of Death by Pharmacological Heart Failure Treatment: A Meta-Analysis of Randomized Clinical Trials.
المؤلفون: Hansen MR; Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark; Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark; Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: mrix@health.sdu.dk., Hróbjartsson A; Center for Evidence-Based Medicine, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Odense Explorative Patient Data Network (OPEN), Odense University Hospital, Odense, Denmark., Videbæk L; Department of Cardiology, Odense University Hospital, Odense, Denmark., Ennis ZN; Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark., Pareek M; Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark; Department of Cardiology, North Zealand Hospital, Hillerød, Denmark; Department of Internal Medicine, Yale New Haven Hospital, New Haven, Conn., Paulsen NH; Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark., Broe M; Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark., Olesen M; Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark., Pottegård A; Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark., Damkier P; Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Hallas J; Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark; Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark.
المصدر: The American journal of medicine [Am J Med] 2020 Jun; Vol. 133 (6), pp. e280-e289. Date of Electronic Publication: 2020 Mar 13.
نوع المنشور: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Systematic Review
اللغة: English
بيانات الدورية: Publisher: Excerpta Medica Country of Publication: United States NLM ID: 0267200 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1555-7162 (Electronic) Linking ISSN: 00029343 NLM ISO Abbreviation: Am J Med Subsets: MEDLINE
أسماء مطبوعة: Publication: New York, NY : Excerpta Medica
Original Publication: New York, Donnelly.
مواضيع طبية MeSH: Survival Rate*, Adrenergic beta-Antagonists/*therapeutic use , Angiotensin Receptor Antagonists/*therapeutic use , Angiotensin-Converting Enzyme Inhibitors/*therapeutic use , Cardiovascular Agents/*therapeutic use , Heart Failure/*drug therapy , Ivabradine/*therapeutic use , Mineralocorticoid Receptor Antagonists/*therapeutic use, Cause of Death ; Drug Therapy, Combination ; Heart Failure/mortality ; Humans ; Randomized Controlled Trials as Topic
مستخلص: Background: Outcome postponement has been proposed as an effect measure for preventive drug treatment. It describes the average delay of the investigated unwanted clinical event, achieved by taking medication. The objective was to estimate postponement of death for the following heart failure medications compared to placebo: beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), ARB added to ACE inhibitors, aldosterone antagonists, ivabradine, and renin antagonists.
Methods: We searched Medline and Embase from inception of databases until October 2017. Eligibility criteria were randomized placebo-controlled heart failure trials, including at least 1000 participants, with survival as a prespecified outcome and a minimum trial duration of 1 year. We calculated the outcome postponement by modeling the area between survival curves. This area was modeled on the basis of the hazard ratio or relative risk, the rate of mortality in the placebo group, and the trial duration. All results were standardized to a 3-year trial duration to ensure comparability between treatments.
Results: We identified 14 eligible trials, with a total of 52,014 patients. The results in terms of postponement of all-cause mortality was: beta-blockers 43.7 days (95% confidence interval [95% CI], 20.8-66.5), ACE inhibitors 41.0 days (95% CI, 18.8-63.3), and aldosterone-antagonists 41.3 days (95% CI, 14.3,68.4).
Conclusion: The modeled outcome postponement estimates reiterate beta-blockers, ACE inhibitors, and aldosterone antagonists as the mainstay of heart failure treatment. Furthermore, ivabradine or ARBs added to ACE inhibitors results in no statistically significant gain in survival.
(Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Effect measure; Heart failure; Meta-analysis; Outcome postponement; Randomized Controlled Trial
المشرفين على المادة: 0 (Adrenergic beta-Antagonists)
0 (Angiotensin Receptor Antagonists)
0 (Angiotensin-Converting Enzyme Inhibitors)
0 (Cardiovascular Agents)
0 (Mineralocorticoid Receptor Antagonists)
3H48L0LPZQ (Ivabradine)
تواريخ الأحداث: Date Created: 20200317 Date Completed: 20200814 Latest Revision: 20200814
رمز التحديث: 20221213
DOI: 10.1016/j.amjmed.2019.11.015
PMID: 32173347
قاعدة البيانات: MEDLINE
الوصف
تدمد:1555-7162
DOI:10.1016/j.amjmed.2019.11.015