READY: relative efficacy of loop diuretics in patients with chronic systolic heart failure—a systematic review and network meta-analysis of randomised trials
| Autor: | Lutz Frankenstein, Hugo A. Katus, Hanna Fröhlich, Mirjam Seiz, Tobias Täger |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class 030204 cardiovascular system & hematology Placebo Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine Bias Sodium Potassium Chloride Symporter Inhibitors Internal medicine Clinical endpoint medicine Humans media_common.cataloged_instance 030212 general & internal medicine European union Randomized Controlled Trials as Topic media_common business.industry Loop diuretic medicine.disease Clinical trial Treatment Outcome Azosemide Heart failure Meta-analysis Chronic Disease Cardiology and Cardiovascular Medicine business Heart Failure Systolic |
| Zdroj: | Heart Failure Reviews. 24:461-472 |
| ISSN: | 1573-7322 1382-4147 |
| DOI: | 10.1007/s10741-019-09771-8 |
| Popis: | The majority of patients with chronic heart failure (HF) receive long-term treatment with loop diuretics. The comparative effectiveness of different loop diuretics is unknown. We searched PubMed, clinicaltrials.gov , the Cochrane Central Register of Controlled Trials and the European Union Clinical Trials Register for randomised clinical trials exploring the efficacy of the loop diuretics azosemide, bumetanide, furosemide or torasemide in patients with HF. Comparators included placebo, standard medical care or any other active treatment. The primary endpoint was all-cause mortality. Secondary endpoints included cardiovascular mortality, HF-related hospitalisation and any combined endpoint thereof. Hypokalaemia and acute renal failure were defined as additional safety endpoints. Evidence was synthesised using network meta-analysis (NMA). Thirty-four trials reporting on 2647 patients were included. The overall quality of evidence was rated as moderate. NMA demonstrated no significant differences between loop diuretics with respect to all-cause mortality, cardiovascular mortality or hypokalaemia. In contrast, torasemide ranked best in terms of HF hospitalisation, and there was a trend towards benefits with torasemide with regard to occurrence of acute renal failure. Sensitivity analyses excluding trials with a follow-up |
| Databáze: | OpenAIRE |
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