scholarly journals CARVEDILOL VERSUS METOPROLOL SUCCINATE FOR ALL-CAUSE MORTALITY IN PATIENTS WITH HEART FAILURE WITH EJECTION FRACTION - A SYSTEMATIC REVIEW AND META-ANALYSIS

2021 ◽  
Vol 77 (18) ◽  
pp. 738
Author(s):  
Tushar Sharma ◽  
Rahul Chaudhary
2021 ◽  
Vol 2021 (1) ◽  
pp. 36-39
Author(s):  
E.Ya. Nikolenko ◽  
◽  
K.V. Vovk ◽  
O.L. Pavlova ◽  
O.O. Salun ◽  
...  

Choosing the best drug for the treatment of cardiac patients remains one of the most important aspects of medical practice. The purpose of this review is to select the optimal beta-blocker for the treatment of patients with chronic heart failure and patients with acute myocardial infarction by comparing the efficacy of carvedilol and metoprolol succinate, as both drugs significantly reduce mortality rates and reduce hospitalization. The results of meta-analyzes, randomized trials comparing the efficacy of carvedilol and metoprolol succinate in the treatment of patients with heart failure with reduced ejection fraction and patients with acute myocardial infarction were analyzed. Conflicting data received. According to the study “Effect of carvedilol vs metoprolol succinate on mortality in heart failure with reduced ejection fraction”, a meta-analysis published in the American Journal of Cardiology in 2013, carvedilol is significantly more effective than metoprolol succinate in treatment of patients with heart failure with reduced ejection fraction and patients with acute myocardial infarction, while meta-analyzes of 2015 and 2017 showed no preference for carvedilol over metoprolol succinate. Based on the results, concluded that the data obtained is not sufficient to argue that carvedilol is more effective than metoprolol succinate for this category of patients in terms of reducing the risk of all-cause mortality, cardiovascular mortality, and reducing hospitalization. This problem requires further extensive research.


2021 ◽  
pp. 1-8
Author(s):  
Huiyang Li ◽  
Peng Zhou ◽  
Yikai Zhao ◽  
Huaichun Ni ◽  
Xinping Luo ◽  
...  

Abstract Objective: The aim of this meta-analysis was to investigate the association between malnutrition assessed by the controlling nutritional status (CONUT) score and all-cause mortality in patients with heart failure. Design: Systematic review and meta-analysis. Settings: A comprehensively literature search of PubMed and Embase databases was performed until 30 November 2020. Studies reporting the utility of CONUT score in prediction of all-cause mortality among patients with heart failure were eligible. Patients with a CONUT score ≥2 are grouped as malnourished. Predictive values of the CONUT score were summarized by pooling the multivariable-adjusted risk ratios (RR) with 95 % CI for the malnourished v. normal nutritional status or per point CONUT score increase. Participants: Ten studies involving 5196 patients with heart failure. Results: Malnourished patients with heart failure conferred a higher risk of all-cause mortality (RR 1·92; 95 % CI 1·58, 2·34) compared with the normal nutritional status. Subgroup analysis showed the malnourished patients with heart failure had an increased risk of in-hospital mortality (RR 1·78; 95 % CI 1·29, 2·46) and follow-up mortality (RR 2·01; 95 % CI 1·58, 2·57). Moreover, per point increase in CONUT score significantly increased 16% risk of all-cause mortality during the follow-up. Conclusions: Malnutrition defined by the CONUT score is an independent predictor of all-cause mortality in patients with heart failure. Assessment of nutritional status using CONUT score would be helpful for improving risk stratification of heart failure.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
O.M Aldaas ◽  
F Lupercio ◽  
C.L Malladi ◽  
P.S Mylavarapu ◽  
D Darden ◽  
...  

Abstract Background Catheter ablation improves clinical outcomes in symptomatic atrial fibrillation (AF) patients with heart failure (HF) with reduced ejection fraction (HFrEF). However, the role of catheter ablation in HF patients with a preserved ejection fraction (HFpEF) is less clear. Purpose To determine the efficacy of catheter ablation of AF in patients with HFpEF relative to those with HFrEF. Methods We performed an extensive literature search and systematic review of studies that compared AF recurrence at one year after catheter ablation of AF in patients with HFpEF versus those with HFrEF. Risk ratio (RR) 95% confidence intervals were measured using the Mantel-Haenszel method for dichotomous variables, where a RR<1.0 favors the HFpEF group. Results Four studies with a total of 563 patients were included, of which 312 had HFpEF and 251 had HFrEF. All patients included were undergoing first time catheter ablation of AF. Patients with HFpEF experienced similar recurrence of AF one year after ablation on or off antiarrhythmic drugs compared to those with HFrEF (RR 0.87; 95% CI 0.69–1.10, p=0.24), as shown in Figure 1. Recurrence of AF was assessed with electrocardiography, Holter monitoring, and/or event monitoring at scheduled follow-up visits and final follow-up. Conclusion Based on the results of this meta-analysis, catheter ablation of AF in patients with HFpEF appears as efficacious in maintaining sinus rhythm as in those with HFrEF. Funding Acknowledgement Type of funding source: None


2022 ◽  
Vol 11 (2) ◽  
pp. 288
Author(s):  
Emmanuel Androulakis ◽  
Catrin Sohrabi ◽  
Alexandros Briasoulis ◽  
Constantinos Bakogiannis ◽  
Bunny Saberwal ◽  
...  

Background: Catheter ablation (CA) for atrial fibrillation (AF) has been proposed as a means of improving outcomes among patients with heart failure and reduced ejection fraction (HFrEF) who are otherwise receiving appropriate treatment. Unlike HFrEF, treatment options are more limited in patients with preserved ejection fraction (HFpEF) and the data pertaining to the management of AF in these patients are controversial. The aim of this systematic review and meta-analysis was to investigate the effects of CA on outcomes of patients with AF and HFpEF, such as functional status, post-procedural complications, hospitalization, morbidity and mortality, based on data from observational studies. Methods: We systematically searched the electronic databases MEDLINE, PUBMED, EMBASE and the Cochrane Library for Central Register of Clinical Trials until May 2020. Results: Overall, the pooling of our data showed that sinus rhythm was achieved long-term in 58.0% (95% CI 0.44–0.71). Long-term AF recurrence was noticed in 22.3% of patients. Admission for HF occurred in 6.2% (95% CI 0.04–0.09) whilst all-cause mortality was identified in 6.3% (95% CI 0.02–0.13). Conclusion: This meta-analysis is the first to focus on determining the benefits of a rhythm control strategy for patients with AF and HFpEF using CA, suggesting it may be worthwhile to investigate the effects of a CA rhythm control strategy as the default treatment of AF in HFpEF patients in randomized trials.


2021 ◽  
Author(s):  
Junpeng Xu ◽  
Ruixiang Zeng ◽  
Xiaoyi Mai ◽  
Wenjun Pan ◽  
Yuzhuo Zhang ◽  
...  

Abstract BackgroundAccumulating evidence suggests that HbA1c levels, a common clinical indicator of chronic glucose metabolism over the preceding 2-3 months, are independent risk factor for cardiovascular disease, including heart failure. The aim of this protocol is to conduct a systematic review and meta-analysis to assess the possible predictive value of HbA1c on mortality and readmission in patients with heart failure.MethodsA systematic and comprehensive search will be performed using PubMed, Embase, Central and other databases before August 2021 to identify relevant trials. All-cause mortality is the pre-specified primary endpoint. Cardiovascular death and heart failure readmission are secondary interested endpoints. We will only include prospective and retrospective cohort trials and place no restrictions on the language, race, region and publication period. The Newcastle-Ottawa Scale will be used to assess the quality of each trial included. If there are sufficient trials, we will conduct meta-analysis with pooled relative risks and corresponding 95% confidence interval to evaluate the possible predictive value of HbA1c on mortality and readmission. Otherwise, we will undertake a narrative synthesis. Heterogeneity and publication bias will be assessed. If heterogeneity is significant among included trails, a sensitivity analysis or subgroup analysis will be used to explore the source of heterogeneity, such as diverse types of heart failure or patients with diabetes and non-diabetes. Also, we will conduct meta-regression to examine the time-effect and treatment-effect modifiers on all-cause mortality compared between different quantile of HbA1c levels. Finally, a restricted cubic spline model may be used to explore the dose-response relationship between HbA1c and adverse outcomes.DiscussionThis planned analysis is anticipated to identify the predictive value of HbA1c on mortality and readmission in patients with heart failure. Improved understanding of different HbA1c levels and their specific effect on diverse types of heart failure or patients with diabetes and non-diabetes is expected to be figured out. Also, a dose-response relationship or optimal range of HbA1c will be determined to instruct clinicians and patients.PROSPERO registration detailsCRD42021276067


2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Theodora Nikolaidou ◽  
Nathan A. Samuel ◽  
Carl Marincowitz ◽  
David J. Fox ◽  
John G. F. Cleland ◽  
...  

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