Effects of aliskiren on mortality, cardiovascular outcomes and adverse events in patients with diabetes and cardiovascular disease or risk: A systematic review and meta-analysis of 13,395 patients

Autor: Sean L. Zheng, Alistair J. Roddick, Salma Ayis
Rok vydání: 2017
Předmět:
medicine.medical_specialty
Endocrinology
Diabetes and Metabolism
Disease
030204 cardiovascular system & hematology
Risk Assessment
Renin-Angiotensin System
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Fumarates
systematic review
Risk Factors
direct renin inhibitor
Internal medicine
Diabetes mellitus
Diabetes Mellitus
Odds Ratio
Internal Medicine
medicine
Humans
renin–angiotensin inhibition
030212 general & internal medicine
Adverse effect
Chi-Square Distribution
diabetes
business.industry
renin-angiotensin inhibition
Cardiovascular Agents
Original Articles
Odds ratio
Aliskiren
medicine.disease
Amides
meta-analysis
Treatment Outcome
Endocrinology
chemistry
Cardiovascular Diseases
Meta-analysis
Concomitant
Cardiology and Cardiovascular Medicine
business
Risk assessment
Meta-Analysis
Zdroj: Zheng, S L, Roddick, A J & Ayis, S 2017, ' Effects of aliskiren on mortality, cardiovascular outcomes and adverse events in patients with diabetes and cardiovascular disease or risk : A systematic review and meta-analysis of 13,395 patients ', Diabetes & vascular disease research, vol. 14, no. 5 . https://doi.org/10.1177/1479164117715854
Diabetes & Vascular Disease Research
ISSN: 1752-8984
1479-1641
DOI: 10.1177/1479164117715854
Popis: Background:Aliskiren was shown to increase adverse events in patients with diabetes and concomitant renin–angiotensin blockade. We aim to investigate the efficacy and safety of aliskiren in patients with diabetes and increased cardiovascular risk or established cardiovascular disease.Methods:MEDLINE and Embase were searched for prospective studies comparing addition of aliskiren to standard medical therapy in patients with diabetes and cardiovascular disease, or ⩾1 additional cardiovascular risk factor (hypertension, abnormal lipid profile, microalbuminuria/proteinuria, chronic kidney disease). Relative risk for efficacy (all-cause mortality, combined cardiovascular mortality and hospitalisation) and safety (hyperkalaemia, hypotension, renal impairment) outcomes was calculated.Results:Of 2151 studies identified in the search, seven studies enrolling 13,395 patients were included. Aliskiren had no effect on all-cause mortality (relative risk: 1.05, 95% confidence interval: 0.90 to 1.24, p = 0.53), or combined cardiovascular mortality or heart failure hospitalisation (relative risk: 1.07, 95% confidence interval: 0.81 to 1.40, p = 0.64). Patients receiving aliskiren had a greater risk of developing hyperkalaemia (relative risk: 1.32, 95% confidence interval: 1.14 to 1.53, p = 0.0003) and renal impairment (relative risk: 1.15, 95% confidence interval: 1.02 to 1.30, p = 0.03), but not hypotension.Conclusion:Patients with diabetes and cardiovascular disease or cardiovascular risk do not benefit from the addition of aliskiren to standard medical therapy. Detrimental safety profile in pooled analysis supports current warnings.
Databáze: OpenAIRE
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