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Inhibidores de la fosfodiesterasa 5 para el tratamiento de la insuficiencia cardiaca: revisión sistemática y metaanálisis de ensayos clínicos aleatorizados.

Authors :
Monzón-Herrera, Ramiro
Listorti, Federico
Vensentini, Natalia
Mariani, Javier
Source :
Archivos de Cardiología de México. jul-sep2024, Vol. 94 Issue 3, p309-323. 15p.
Publication Year :
2024

Abstract

Objective: The treatment with phosphodiesterase-5 (PDE-5) inhibitors was postulated in heart failure (HF). We conducted a systematic review and a meta-analysis on their beneficial and adverse effects in patients with HF. Method: A meta-analysis of randomized trials evaluating the chronic use of PDE-5 inhibitors in patients with HF was conducted. Endpoints included death, HF hospitalizations, functional capacity, pulmonary pressures, quality of life, and adverse effects. Random-effects models were used to pool outcomes. Categorical data were summarized with relative risks (RR) and 95% confidence intervals (95%CI), and continuous data with weighted mean differences and standardized mean differences. Results: Sixteen studies (1119 participants) were included. No effect was observed on mortality (RR: 1.16; 95%CI: 0.50-2.66; I2: 0.0%) or HF hospitalizations (RR: 0.75; 95%CI: 0.41-1.37; I2: 38.7%). Treatment significantly reduced pulmonary systolic pressure (-10.64 mmHg; 95%CI: -5.14 to -16.15 mmHg; I2: 96.0%), and increased peak oxygen consumption (2.06 ml/kg/min; 95%CI: 0.40-3.72; I2: 89.6%), although with high inconsistency. There were no significant effects on quality of life (-0.15; 95%CI: -0.48-0.18; I2: 0.0%). On the other hand, the risk of headaches was increased (RR: 1.63; 95%CI: 1.11-2.39; I2: 0.0%). Publication bias was identified for HF hospitalizations. Conclusions: Current data suggest that PDE-5 inhibitors therapy does not improve prognosis or quality of life among HF patients. Hemodynamic and functional effects could be relevant, and more studies are necessary to define its role. [ABSTRACT FROM AUTHOR]

Details

Language :
Spanish
ISSN :
14059940
Volume :
94
Issue :
3
Database :
Academic Search Index
Journal :
Archivos de Cardiología de México
Publication Type :
Academic Journal
Accession number :
178498613
Full Text :
https://doi.org/10.24875/ACM.23000209