Evaluation of the effectiveness of infusion of bone marrow derived cell in patients with heart failure: A network meta-analysis of randomized clinical trials and cohort studies

Anemia is common in heart failure (HF) patients and has been well-established as a risk factor for increased risk of HF hospitalization and mortality. Treatment with erythropoietin stimulating agents (ESA) has increased hemoglobin, but outcomes trials are limited and use of ESA has been controversial given disparate results in other populations. This meta-analysis aimed to evaluate the impact of ESA and iron on outcomes in HF patients. A systematic review of four databases was conducted in April 2008 (n = 95 unique trials). Analysis inclusion criteria included randomized controlled trial to ESA/iron with clinically defined HF, yielding 10 eligible trials published between 6/01–3/08. Data was independently extracted and cross-checked for accuracy and reliability (2 investigators). A total of 768 subjects (421 treated and 338 controls) are included (Characteristics in Table 1 ). Randomization to ESA produced a significant improvement in exercise capacity 0.39 standard units [95% CI 0.1– 0.6, p = 0.001], a 5.72% [95% CI 1.2–10.3, p = 0.014] increase in left ventricle ejection fraction and a 0.23 mg/dL [95% CI 0.4 – 0.1 p = 0.001] reduction in serum creatinine. There was no difference in all-cause mortality - RR 0.79 [95% CI 0.49, 1.26, p = 0.320]. Trends were noted in reduced hospitalization rates, decreased brain natriuretic peptide, and improved quality of life. Meta-analysis of randomized studies of treatment of anemia in HF patients suggests significant benefit in exercise capacity, left ventricular ejection fraction, and serum creatinine. There does not appear to be excess mortality with ESA/iron treatment. Despite favorable findings, definitive randomized clinical trials are needed to assess the role of this treatment modality in HF management. Table 1. Baseline Patient and Study Characteristics

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The safety and efficacy of SDLT-2 (Sodium-glucose co-transporter 2) inhibitor versus placebo in the treatment of heart failure in patients with or without T2DM (Type 2 diabetes mellitus): A Systemic Review and Meta-analysis.

10.21203/rs.3.rs-16652/v1 ◽

2020 ◽

Author(s):

Qian Zhang ◽

Xiaofei Wang ◽

Peipei Ge ◽

Aizhen Hu ◽

Xuexun Li

Keyword(s):

Diabetes Mellitus ◽

Heart Failure ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Sglt2 Inhibitor ◽

Systemic Review ◽

Cochrane Library ◽

Volume Depletion ◽

Patients With Heart Failure ◽

Safety Outcomes

Abstract Background Sodium-glucose co-transporter 2 (SGLT2) inhibitor which is a type of drug used for the treatment of diabetes mellitus, has been reported by many trials that it could be beneficial for patients with established heart failure. A meta-analysis on this subject could obtain more reliable estimates of the efficacy and safety outcomes. Methods A systematic review and meta-analysis of randomized, placebo-controlled trials of SGLT2 inhibitor in patients with heart failure was conducted. We searched PubMed, Cochrane Library, and Web of Science for trials published from inception to March, 2018. PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was used to conduct the review. For quality assessment of included studies. The methodological quality of the included trials was assessed using the Cochrane tool for assessing randomized clinical trials (RCT). Efficacy outcomes included hospitalization for heart failure and all-cause death. Safety outcomes consisted of serious adverse event (SAE) and volume depletion. Results We included data from 5 identified studies and 8775 patients (aged 64.9, female 29.8%). A total of 3930 (44.8%) patients were known to have diabetes mellitus. Compared with placebo, SGLT2 inhibitor decrease the incidence of hospitalization for heart failure (RR 0.692; 95%CI, 0.611-0.784 P<0.001), and all-cause death (RR 0.824; 95%CI, 0.736-0.922 P=0.001). The incidence of SAE in patients with a treatment of SGLT2 inhibitor was low (RR 0.869; 95%CI, 0.779-0.970 P=0.012). SGLT2 inhibitor didn’t increase the incidence of volume depletion (RR1.165, 95%CI, 0.977-1.390 P=0.089). Conclusion Our results confirm that SGLT2 inhibitor is effective and safe for patients with heart failure regardless of presence of diabetes mellitus.

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Prognostic Value of Red Blood Cell Distribution Width for Patients with Heart Failure: A Systematic Review and Meta-Analysis of Cohort Studies

PLoS ONE ◽

10.1371/journal.pone.0104861 ◽

2014 ◽

Vol 9 (8) ◽

pp. e104861 ◽

Cited By ~ 44

Author(s):

Yuan-Lan Huang ◽

Zhi-De Hu ◽

Shi-Jian Liu ◽

Yi Sun ◽

Qin Qin ◽

...

Keyword(s):

Heart Failure ◽

Systematic Review ◽

Blood Cell ◽

Cohort Studies ◽

Prognostic Value ◽

Meta Analysis ◽

Cell Distribution ◽

Distribution Width ◽

Patients With Heart Failure ◽

Red Blood Cell Distribution

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

The American Journal of Medicine ◽

10.1016/j.amjmed.2019.11.015 ◽

2020 ◽

Vol 133 (6) ◽

pp. e280-e289

Author(s):

Morten Rix Hansen ◽

Asbjørn Hróbjartsson ◽

Lars Videbæk ◽

Zandra Nymand Ennis ◽

Manan Pareek ◽

...

Keyword(s):

Heart Failure ◽

Clinical Trials ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Heart Failure Treatment ◽

Failure Treatment

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Inspiratory Muscle Training in Patients with Heart Failure

Journal of Clinical Medicine ◽

10.3390/jcm9061710 ◽

2020 ◽

Vol 9 (6) ◽

pp. 1710

Author(s):

Hugo Fernandez-Rubio ◽

Ricardo Becerro-de-Bengoa-Vallejo ◽

David Rodríguez-Sanz ◽

César Calvo-Lobo ◽

Davinia Vicente-Campos ◽

...

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Clinical Trials ◽

Exercise Training ◽

Meta Analysis ◽

Experimental Studies ◽

Inspiratory Muscle ◽

Muscle Training ◽

Patients With Heart Failure

Background: Prior systematic reviews and meta-analysis addressed that inspiratory muscle training (IMT) improved inspiratory muscle weakness, cardiorespiratory fitness and quality of life similar to conventional exercise training as a first alternative in deconditioned patients with heart failure (HF) lead to a better adaptation to posterior exercise training. The heterogeneity and variability in a wide range of new studies about this topic led to the necessity of an updated and comprehensive narrative review. The present review aimed to analyze and update the most relevant studies about IMT in patients who suffer from HF. Methods: A narrative review was carried out about IMT in HF patients including 26 experimental studies divided into 21 clinical trials and 5 quasi-experimental studies identified through database searching in PubMed, Cochrane and PEDro. Results: There is enough evidence to state that IMT produces improvements in functional capacity of patients with HF. Nevertheless, there is not enough evidence to support that IMT could improve cardiovascular parameters, blood biomarkers or quality of life in these patients. Conclusions: Thus, IMT may be recommended to improve functional capacity in patients who suffer from HF; nevertheless, more evidence is needed regarding cardiovascular parameters, biomarkers and quality of life. Furthermore, mortality or HF hospitalization was not evaluated and most studies were not longer than 3 months. According to IMT protocols and study designs heterogeneity and mid-term follow-up, further investigations through high-quality long-term randomized clinical trials should be performed to achieve systematic reviews and meta-analysis to support strong evidence for IMT in HF patients.

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