Comparative effects of furosemide and other diuretics in the treatment of heart failure: a systematic review and combined meta-analysis of randomized controlled trials
| Autor: | Mostafa Mahmoud Fahmy, Peter Samuel Eid, Le Huu Nhat Minh, Hend Kandil, Jaffer Shah, Nguyen Tien Huy, Nguyen Lam Vuong, Luc Minh Duy, Ashraf Shinkar, Muhammed Khaled Elfaituri, Manal Mahmoud Abd Elrahman, Van Buu Dan Do, Kenji Hirayama, Ahmad Helmy Zayan, Dao Ngoc Hien Tam, Doaa Alaa Ibrahim, Mostafa A. Shehata, Mahmoud Ahmed Abouibrahim |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Side effect medicine.medical_treatment 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Furosemide Internal medicine Medicine Humans 030212 general & internal medicine Adverse effect Diuretics Randomized Controlled Trials as Topic Heart Failure business.industry medicine.disease Torsemide Heart failure Meta-analysis Cardiology Diuretic Cardiology and Cardiovascular Medicine business Hypervolemia medicine.drug |
| Zdroj: | Heart failure reviews. 26(1) |
| ISSN: | 1573-7322 |
| Popis: | Diuretics have an essential role in the management of heart failure (HF). However, each drug has its own benefit and side effect. Side effects include fluid, electrolyte abnormalities, and acid-base disturbance. These adverse effects of diuretics predispose patients to serious cardiac arrhythmias and may increase the risk of arrhythmic mortality. Herein, we aim to summarize the relative efficacy and safety of all available diuretics used in the treatment of patients with HF. In June 2017, a systematic electronic database search was conducted in nine databases. All randomized controlled trials (RCTs) comparing the different diuretics used in HF were included for meta-analysis. The protocol was registered in Prospero with CRD42018084819. Among the included 54 studies (10,740 patients), 34 RCTs were eligible for quantitative network meta-analysis (NMA) and traditional meta-analysis while the other 20 studies were qualitatively analyzed. Our results showed that azosemide and torasemide caused a significant reduction in brain natriuretic peptide (BNP) level. Torasemide also caused a significant decrease in collagen volume fraction (CVF) and edema. No significant difference between the agents concerning glomerular filtration rate (GFR), water extraction, and sodium excretion was demonstrated. Regarding side effects, no significant difference among diuretics was observed in terms of hospital readmission and mortality rates. Diuretics are the main treatment of hypervolemia in HF patients. The choice of appropriate diuretic is essential for successful management and is mainly guided by patient clinical situations and the presence of other co-morbidities. |
| Databáze: | OpenAIRE |
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