The Effect of Trimetazidine Added to Pharmacological Treatment on All-Cause Mortality in Patients with Systolic Heart Failure

Cardiology ◽  
2015 ◽  
Vol 131 (1) ◽  
pp. 22-29 ◽  
Author(s):  
Stefan Grajek ◽  
Michał Michalak
Keyword(s):  
Heart Failure ◽  
Pharmacological Treatment ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Antioxidant Properties ◽  
Systolic Heart Failure ◽  
Cochrane Collaboration ◽  
Positive Effects ◽  
Prospective Randomized Controlled Trial ◽  
All Cause Mortality

The anti-ischemic agent trimetazidine (TMZ) added to pharmacological treatment appears to have positive effects on cardiac parameters of patients with heart failure (HF) as a result of specific antioxidant properties. Objectives: We aimed to verify whether the marked improvement provided by TMZ in echocardiographic and clinical parameters was likely to translate into reduced all-cause mortality in systolic HF patients. Methods: Meta-analysis of available published prospective randomized controlled trial (RCT) data (1967-2014) retrieved from PubMed, Web of Science and Cochrane Collaboration. Results: A total of 326 patients from 3 RCTs were analyzed: 164 who received TMZ on top of pharmacological HF therapy and 162 controls. Study durations ranged from 12 to 48 months. The analysis had no publication bias and the studies were homogeneous (p = 0.442, I2 = 0). The results show a significant effect of TMZ on the reduction of all-cause mortality (RR = 0.283, p < 0.0001). The rate of events attributable to the drug was lower with TMZ than it was among control patients. Conclusion: This meta-analysis suggests that in patients with HF, TMZ given as an add-on therapy is likely to provide a protective effect, reduce all-cause mortality and increase event-free survival, and could be an effective and useful adjunct to our armamentarium for the treatment of HF patients.

Catheter ablation outscores all other treatment modalities in reducing all-cause mortality and heart failure related morbidity in patients of persistent atrial fibrillation with systolic heart failure

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
D Khanra ◽  
A Mukherjee ◽  
S Deshpande ◽  
D Padmanabhan ◽  
S Mohan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Catheter Ablation ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Systolic Heart Failure ◽  
Individual Treatment ◽  
Published Data ◽  
Bayesian Modelling ◽  
All Cause Mortality ◽  
Pair Wise Comparison

Abstract Funding Acknowledgements Type of funding sources: None. Background Catheter ablation in the setting of persistent AF (PeAF) with heart failure (HF) is challenging and often has poor outcome. However, guideline and studies indicate ablation strategy in this group to reduce mortality and HF-related hospitalization. Purpose We have conducted a network meta-analysis (NMA) of all-cause mortality and improvement of HF-related QOL in patients of PeAF with systolic heart failure comparing  rate controlling drugs (RCDs), anti-arrhythmic drugs (AAD), catheter ablation (CA) of PeAF and AV nodal ablation with univentricular or biventricular pacing (AVNA). Method Bayesian network meta-analysis of randomized controlled studies comparing mortality and QOL among individual treatment arms (e.g. RCDs, AADs, CA and AVNA) and pair-wise network meta-analysis comparing CA and other treatment arms (RCD, AAD and AVNA) were performed using MetInsight V3.  Markov chain Monte Carlo (MCMC) modeling was used to estimate the relative ranking probability of each treatment group. Results Published data of 14 studies including 3698 patients were included in the NMA with a median follow-up of two years (1A, 2A). The Bayesian modelling with MCMC analysis for pair-wise comparison clearly demonstrated that, AAD [OR (95% CrI): 2.10 (0.43-9.0)], AVNA [OR (95% CrI): 1.32 (0.14-11.7)] and RCDs [OR (95% CrI): 2.76 (0.5-14.1)] have higher all-cause mortality than CA but not within the radar of statistical significance (1B). The Bayesian modelling with MCMC analysis for pair-wise comparison clearly demonstrated that, AADs [MD (95% CrI): 8.02 (-8.32-27.8)], AVNA [MD (95% CrI): 17.0 (-1.9-33.1)] and RCDs [MD (95% CrI): 13.0 (0.1-24.5)] have lesser improvement in QOL than CA but not within the radar of statistical significance (2B). Based on the Bayesian model, CA results in lower all-cause mortality and highest improvement of QOL in the patients of AF with HF (3A, 3B). Conclusion This shapes way for future treatment guidelines in patients with PeAF with HF group and points towards CA to be undertaken before medical therapy fails. This also paves way for further research to confirm the longevity of the beneficial effects and to find the specific subsets of AF with HF patients that would be benefited most from CA. Abstract Figure

scholarly journals Long-Term and Short-Term Prognostic Value of Circulating Soluble Suppression of Tumorigenicity-2 Concentration in Chronic Heart Failure: A Systematic Review and Meta-Analysis

Cardiology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Guoqi Dong ◽  
Hao Chen ◽  
Hongru Zhang ◽  
Yihuang Gu
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Prognostic Value ◽  
Web Of Science ◽  
Meta Analysis ◽  
Short Term ◽  
Prisma Statement ◽  
All Cause Mortality ◽  
Increasing Risk

<b><i>Introduction:</i></b> Soluble suppression of tumorigenicity-2 (sST2) has been considered as a prognostic factor of cardiovascular disease. However, the prognostic value of sST2 concentration in chronic heart failure remains to be summarized. <b><i>Methods:</i></b> We searched PubMed, Embase, and Web of Science for eligible studies up to January 1, 2020. Data extracted from articles and provided by authors were used in agreement with the PRISMA statement. The endpoints were all-cause mortality (ACM), cardiovascular mortality (CVM)/heart failure-related hospitalization (HFH), and all-cause mortality (ACM)/heart failure-related readmission (HFR). <b><i>Results:</i></b> A total of 11 studies with 5,121 participants were included in this analysis. Higher concentration of sST2 predicted the incidence of long-term ACM (hazard ratio [HR]: 1.03, 95% confidence interval [CI]: 1.02–1.04), long-term ACM/HFR (HR: 1.42, CI: 1.27–1.59), and long-term CVM/HFH (HR: 2.25, CI: 1.82–2.79), regardless of short-term ACM/HFR (HR: 2.31, CI: 0.71–7.49). <b><i>Conclusion:</i></b> Higher sST2 concentration at baseline is associated with increasing risk of long-term ACM, ACM/HFR, and CVM/HFH and can be a tool for the prognosis of chronic heart failure.

scholarly journals Prediction of all-cause mortality with malnutrition assessed by controlling nutritional status score in patients with heart failure: a systematic review and meta-analysis

2021 ◽  
pp. 1-8
Author(s):  
Huiyang Li ◽  
Peng Zhou ◽  
Yikai Zhao ◽  
Huaichun Ni ◽  
Xinping Luo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Nutritional Status ◽  
Meta Analysis ◽  
Predictive Values ◽  
Increased Risk ◽  
Patients With Heart Failure ◽  
All Cause Mortality ◽  
Conut Score

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.

scholarly journals Exercise training for systolic heart failure: Cochrane systematic review and meta-analysis

2010 ◽  
Vol 12 (7) ◽  
pp. 706-715 ◽  
Author(s):  
Edward J. Davies ◽  
Tiffany Moxham ◽  
Karen Rees ◽  
Sally Singh ◽  
Andrew J.S. Coats ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Exercise Training ◽  
Meta Analysis ◽  
Systolic Heart Failure ◽  
Cochrane Systematic Review

Resistance exercise enhances oxygen uptake without worsening cardiac function in patients with systolic heart failure: a systematic review and meta-analysis

2017 ◽  
Vol 23 (1) ◽  
pp. 73-89 ◽  
Author(s):  
Francisco V. Santos ◽  
Gaspar R. Chiappa ◽  
Sergio Henrique Rodolpho Ramalho ◽  
Alexandra Correa Gervazoni Balbuena de Lima ◽  
Fausto Stauffer Junqueira de Souza ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Oxygen Uptake ◽  
Cardiac Function ◽  
Resistance Exercise ◽  
Meta Analysis ◽  
Systolic Heart Failure

scholarly journals Efficacy and Safety of Oral Anticoagulants in Patients with Systolic Heart Failure in Sinus Rhythm: A Systematic Review and Meta-analysis of Randomized Controlled Trials and Cohort Studies

TH Open ◽  
2020 ◽  
Vol 04 (04) ◽  
pp. e383-e392
Author(s):  
Marie H. Nygaard ◽  
Anne-Mette Hvas ◽  
Erik L. Grove
Keyword(s):  
Heart Failure ◽  
Sinus Rhythm ◽  
Cohort Studies ◽  
Antiplatelet Therapy ◽  
Meta Analysis ◽  
Oral Anticoagulants ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
All Cause Mortality

Abstract Introduction There is conflicting evidence on the risk–benefit ratio of oral anticoagulants (OAC) in heart failure (HF) patients without atrial fibrillation. We aimed to evaluate the efficacy and safety of OAC in HF patients in sinus rhythm. Methods A systematic literature search was conducted using PubMed and Embase. We included randomized controlled trials (RCT) and cohort studies, comparing OAC with antiplatelet or no treatment/placebo in patients with HF. Outcomes evaluated were stroke, myocardial infarction (MI), all-cause mortality, and major bleeding. Results Five RCTs and three cohort studies were included. OAC was associated with a reduced risk of ischemic stroke when compared with no treatment/placebo (odds ratio [OR] = 0.67, 95% confidence interval [CI]: [0.47, 0.94]) and antiplatelet therapy (OR = 0.55, 95% CI: [0.37, 0.81]). No significant reduction was found in MI, when OAC was compared with no treatment/placebo (OR = 0.82, 95% CI: [0.63, 1.07]) or antiplatelet therapy (OR = 1.04, 95% CI: [0.60, 1.81]). The all-cause mortality analysis showed no significant reduction when comparing OAC with no treatment/placebo (OR = 0.99, 95% CI: [0.87, 1.12]) or antiplatelet therapy (OR = 1.00, 95% CI: [0.86, 1.16]). The nonsignificant effect of OAC on all-cause mortality was supported by a meta-analysis of the three cohort studies (OR = 1.02, 95% CI: [0.75, 1.38]). Patients treated with OAC had a significantly higher risk of major bleeding than patients receiving antiplatelet therapy (OR = 2.16, 95% CI: [1.55, 3.00]) and a numerically higher risk when compared with no treatment/placebo (OR = 2.38, 95% CI: [0.87, 6.49]). Conclusion The present study does not support the routine use of OAC in patients with HF in sinus rhythm.

Fried-food consumption and risk of cardiovascular disease and all-cause mortality: a meta-analysis of observational studies

Heart ◽  
2021 ◽  
pp. heartjnl-2020-317883 ◽  
Author(s):  
Pei Qin ◽  
Ming Zhang ◽  
Minghui Han ◽  
Dechen Liu ◽  
Xinping Luo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Food Consumption ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Case Control ◽  
Fried Food ◽  
Major Cardiovascular Events ◽  
All Cause Mortality

ObjectiveWe performed a meta-analysis, including dose–response analysis, to quantitatively determine the association of fried-food consumption and risk of cardiovascular disease and all-cause mortality in the general adult population.MethodsWe searched PubMed, EMBASE and Web of Science for all articles before 11 April 2020. Random-effects models were used to estimate the summary relative risks (RRs) and 95% CIs.ResultsIn comparing the highest with lowest fried-food intake, summary RRs (95% CIs) were 1.28 (1.15 to 1.43; n=17, I2=82.0%) for major cardiovascular events (prospective: 1.24 (1.12 to 1.38), n=13, I2=75.7%; case–control: 1.91 (1.15 to 3.17), n=4, I2=92.1%); 1.22 (1.07 to 1.40; n=11, I2=77.9%) for coronary heart disease (prospective: 1.16 (1.05 to 1.29), n=8, I2=44.6%; case–control: 1.91 (1.05 to 3.47), n=3, I2=93.9%); 1.37 (0.97 to 1.94; n=4, I2=80.7%) for stroke (cohort: 1.21 (0.87 to 1.69), n=3, I2=77.3%; case–control: 2.01 (1.27 to 3.19), n=1); 1.37 (1.07 to 1.75; n=4, I2=80.0%) for heart failure; 1.02 (0.93 to 1.14; n=3, I2=27.3%) for cardiovascular mortality; and 1.03 (95% CI 0.96 to 1.12; n=6, I2=38.0%) for all-cause mortality. The association was linear for major cardiovascular events, coronary heart disease and heart failure.ConclusionsFried-food consumption may increase the risk of cardiovascular disease and presents a linear dose–response relation. However, the high heterogeneity and potential recall and misclassification biases for fried-food consumption from the original studies should be considered.

Abstract 16170: Impact of Anemia on Outcomes in Patients With Heart Failure With Preserved Ejection Fraction: A Meta-analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Monil Majmundar ◽  
Ashish Kumar ◽  
Rajkumar P Doshi ◽  
Palak shah ◽  
Mariam Shariff ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Publication Bias ◽  
Meta Analysis ◽  
Final Analysis ◽  
Study Data ◽  
Curve Analysis ◽  
Secondary Outcome ◽  
Preserved Ejection Fraction ◽  
All Cause Mortality

Introduction: The effect of anemia on outcomes in Heart failure with preserved ejection fraction (HFpEF) patients is not well-established. Some previous studies have shown increased mortality and hospitalizations in HFpEF patients with anemia. Hypothesis: We hypothesize that anemia affects all-cause mortality and hospitalization in HFpEF patients. Methods: A review of literature for studies comparing outcomes in HFpEF with and without anemia was done in PubMed, MEDLINE, and EMBASE databases through June 1st, 2020. The standard definitions of HFpEF and anemia were used for inclusion criteria. Two investigators extracted the study data independently. The primary outcome of interest was all-cause mortality. The secondary outcome was all-cause hospitalizations. We used the PM estimator of Tau with Knapp-Hartung adjustment to pool adjusted hazard ratio (HR) and 95% confidence interval (CI). P curve analysis was used to assess publication bias. R version 3.6.2 was used for all statistical analyses. Results: Seven studies (23,424 patients) were included in the final analysis. Anemia in patients with HFpEF was associated with higher rates of all-cause mortality [HR: 1.35, 95% CI: 1.17-1.55]. Additionally, anemia in HFpEF patients was associated with higher rates of all-cause hospitalization [HR: 1.22, 95% CI: 1.03-1.44]. P curve analysis for all-cause mortality didn’t report publication bias or P hacking (Figure) . Conclusions: Anemia in HFpEF patients was associated with higher rates of all-cause mortality and all-cause hospitalizations compared to HFpEF patients without anemia.

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