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Impact of Aldosterone Antagonists on Sudden Cardiac Death Prevention in Heart Failure and Post-Myocardial Infarction Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- Source :
- Plos One, vol. 11, no. 2, pp. e0145958, PLoS ONE, PLoS ONE, 2016, 11, pp.e0145958. ⟨10.1371/journal.pone.0145958⟩, PLoS ONE, Vol 11, Iss 2, p e0145958 (2016), PLoS ONE, Public Library of Science, 2016, 11, pp.e0145958. ⟨10.1371/journal.pone.0145958⟩
- Publication Year :
- 2016
-
Abstract
- BACKGROUND AND OBJECTIVES: Sudden cardiac death (SCD) is a severe burden of modern medicine. Aldosterone antagonist is publicized as effective in reducing mortality in patients with heart failure (HF) or post myocardial infarction (MI). Our study aimed to assess the efficacy of AAs on mortality including SCD, hospitalization admission and several common adverse effects. METHODS: We searched Embase, PubMed, Web of Science, Cochrane library and clinicaltrial.gov for randomized controlled trials (RCTs) assigning AAs in patients with HF or post MI through May 2015. The comparator included standard medication or placebo, or both. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Event rates were compared using a random effects model. Prospective RCTs of AAs with durations of at least 8 weeks were selected if they included at least one of the following outcomes: SCD, all-cause/cardiovascular mortality, all-cause/cardiovascular hospitalization and common side effects (hyperkalemia, renal function degradation and gynecomastia). RESULTS: Data from 19,333 patients enrolled in 25 trials were included. In patients with HF, this treatment significantly reduced the risk of SCD by 19% (RR 0.81; 95% CI, 0.67-0.98; p = 0.03); all-cause mortality by 19% (RR 0.81; 95% CI, 0.74-0.88, p
- Subjects :
- [SDV]Life Sciences [q-bio]
Myocardial Infarction
lcsh:Medicine
030204 cardiovascular system & hematology
Biochemistry
law.invention
Sudden cardiac death
chemistry.chemical_compound
Mathematical and Statistical Techniques
0302 clinical medicine
Randomized controlled trial
law
Odds Ratio
Medicine and Health Sciences
Medicine
Prospective Studies
Renal Insufficiency
Lipid Hormones
030212 general & internal medicine
Myocardial infarction
lcsh:Science
Aldosterone
ComputingMilieux_MISCELLANEOUS
Mineralocorticoid Receptor Antagonists
Randomized Controlled Trials as Topic
Multidisciplinary
Mortality rate
3. Good health
Treatment Outcome
Physical Sciences
Cardiology
Gynecomastia
Anatomy
Statistics (Mathematics)
Research Article
medicine.medical_specialty
Modern medicine
Drug Research and Development
Death Rates
Research and Analysis Methods
03 medical and health sciences
Population Metrics
Adverse Reactions
Internal medicine
Humans
Clinical Trials
cardiovascular diseases
Statistical Methods
Adverse effect
Demography
Heart Failure
Pharmacology
Population Biology
business.industry
lcsh:R
Biology and Life Sciences
Renal System
medicine.disease
Survival Analysis
Hormones
Randomized Controlled Trials
Death, Sudden, Cardiac
chemistry
Heart failure
People and Places
Hyperkalemia
lcsh:Q
Clinical Medicine
business
Mathematics
Meta-Analysis
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Database :
- OpenAIRE
- Journal :
- Plos One, vol. 11, no. 2, pp. e0145958, PLoS ONE, PLoS ONE, 2016, 11, pp.e0145958. ⟨10.1371/journal.pone.0145958⟩, PLoS ONE, Vol 11, Iss 2, p e0145958 (2016), PLoS ONE, Public Library of Science, 2016, 11, pp.e0145958. ⟨10.1371/journal.pone.0145958⟩
- Accession number :
- edsair.doi.dedup.....a11a529b1b27d201901608013dae23e5