TY - JOUR
T1 - Vasodilators for Acute Heart Failure
T2 - A Systematic Review with Meta-Analysis
AU - Lukoschewitz, Jasmin D
AU - Miger, Kristina C
AU - Olesen, Anne Sophie O
AU - Caidi, Nora O E
AU - Jørgensen, Caroline K
AU - Nielsen, Olav W
AU - Hassager, Christian
AU - Hove, Jens D
AU - Seven, Ekim
AU - Møller, Jacob E
AU - Jakobsen, Janus Christian
AU - Grand, Johannes
PY - 2024/6
Y1 - 2024/6
N2 - BACKGROUND: Acute heart failure is a public health concern. This study systematically reviewed randomized clinical trials (RCTs) to evaluate vasodilators in acute heart failure.METHODS: The search was conducted across the databases of Medline, Embase, Latin American and the Caribbean Literature on Health Sciences, Web of Science, and the Cochrane Central Register of Controlled Trials. Inclusion criteria consisted of RCTs that compared vasodilators versus standard care, placebo, or cointerventions. The primary outcome was all-cause mortality; secondary outcomes were serious adverse events (SAEs), tracheal intubation, and length of hospital stay. Risk of bias was assessed in all trials.RESULTS: The study included 46 RCTs that enrolled 28,374 patients with acute heart failure. Vasodilators did not reduce the risk of all-cause mortality (risk ratio, 0.95; 95% confidence interval [CI], 0.87 to 1.04; I2=9.51%; P=0.26). No evidence of a difference was seen in the risk of SAEs (risk ratio, 1.01; 95% CI, 0.97 to 1.05; I2=0.94%) or length of hospital stay (mean difference, -0.10; 95% CI, -0.28 to 0.08; I2=69.84%). Vasodilator use was associated with a lower risk of tracheal intubation (risk ratio, 0.54; 95% CI, 0.30 to 0.99; I2=51.96%) compared with no receipt of vasodilators.CONCLUSIONS: In this systematic review with meta-analysis of patients with acute heart failure, vasodilators did not reduce all-cause mortality.
AB - BACKGROUND: Acute heart failure is a public health concern. This study systematically reviewed randomized clinical trials (RCTs) to evaluate vasodilators in acute heart failure.METHODS: The search was conducted across the databases of Medline, Embase, Latin American and the Caribbean Literature on Health Sciences, Web of Science, and the Cochrane Central Register of Controlled Trials. Inclusion criteria consisted of RCTs that compared vasodilators versus standard care, placebo, or cointerventions. The primary outcome was all-cause mortality; secondary outcomes were serious adverse events (SAEs), tracheal intubation, and length of hospital stay. Risk of bias was assessed in all trials.RESULTS: The study included 46 RCTs that enrolled 28,374 patients with acute heart failure. Vasodilators did not reduce the risk of all-cause mortality (risk ratio, 0.95; 95% confidence interval [CI], 0.87 to 1.04; I2=9.51%; P=0.26). No evidence of a difference was seen in the risk of SAEs (risk ratio, 1.01; 95% CI, 0.97 to 1.05; I2=0.94%) or length of hospital stay (mean difference, -0.10; 95% CI, -0.28 to 0.08; I2=69.84%). Vasodilator use was associated with a lower risk of tracheal intubation (risk ratio, 0.54; 95% CI, 0.30 to 0.99; I2=51.96%) compared with no receipt of vasodilators.CONCLUSIONS: In this systematic review with meta-analysis of patients with acute heart failure, vasodilators did not reduce all-cause mortality.
KW - Humans
KW - Heart Failure/drug therapy
KW - Vasodilator Agents/therapeutic use
KW - Acute Disease
KW - Length of Stay
KW - Randomized Controlled Trials as Topic
U2 - 10.1056/EVIDoa2300335
DO - 10.1056/EVIDoa2300335
M3 - Journal article
C2 - 38804781
SN - 2766-5526
VL - 3
JO - NEJM Evidence
JF - NEJM Evidence
IS - 6
ER -