Abstract:
BACKGROUND:Acute heart failure, which requires urgent evaluation and treatment, is a leading cause for admission to the emergency department. The aim of this meta-analysis was to evaluate the effects of tolvaptan on acute heart failure and compare them with the effects of conventional therapy or placebo. METHODS:The electronic databases PubMed, EMBASE, and the Cochrane Controlled Trial registry were searched from their starting dates to October 24, 2016. Two authors independently read the trials and extracted related information from the included studies. We used fixed-effects or random-effects models to assess the overall combined risk estimates according to I2 statistics. Analysis to determine sensitivity and publication bias was conducted. RESULTS:Six randomised controlled trials from eight articles, with a total of 746 patients, were included for analysis. Compared with the control, tolvaptan reduced body weight in two days (WMD 1.35; 95% CI 0.75 to 1.96), elevated sodium level in two days (WMD 2.33; 95% CI 1.08 to 3.57) and five days (WMD 1.57; 95% CI 0.04 to 3.09), and ameliorated symptoms of dyspnoea (RR 0.82; 95% CI 0.71-0.95). However, tolvaptan did not improve long-term (RR 1.04; 95% CI 0.66-1.62) or short-term all-cause mortality (RR 0.89; 95% CI 0.45-1.76), incidence of clinical events (worsening heart failure, RR 0.75; 95% CI 0.50-1.12 and worsening renal function, RR 0.97; 95% CI 0.75-1.27), and length of hospital stay in patients (WMD 0.14; 95% CI -0.29 to 2.38) with acute heart failure. CONCLUSION:Tolvaptan can decrease body weight, increase serum sodium level, and ameliorate some of the congestion symptoms in patients with acute heart failure, which may help avoid the overdose of loop diuretics, especially in patients with renal dysfunction.
journal_name
BMC Cardiovasc Disordjournal_title
BMC cardiovascular disordersauthors
Wang C,Xiong B,Cai Ldoi
10.1186/s12872-017-0598-ysubject
Has Abstractpub_date
2017-06-20 00:00:00pages
164issue
1issn
1471-2261pii
10.1186/s12872-017-0598-yjournal_volume
17pub_type
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pub_type: 杂志文章,meta分析
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pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究
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pub_type: 已发布勘误
doi:10.1186/s12872-019-1195-z
更新日期:2019-10-18 00:00:00
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pub_type: 杂志文章,meta分析,评审
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