Effects of renin–angiotensin–aldosterone system inhibitors on mortality, hospitalization, and diastolic function in patients with HFpEF: A meta-analysis of 13 randomized controlled trials; [Auswirkungen der Inhibitoren des Renin-Angiotensin-Aldosteron-Systems auf Mortalität, Hospitalisation und diastolische Funktion bei Patienten mit HFpEF: Eine Metaanalyse von 13 randomisierten kontrollierten Studien]

被引:0
|
作者
Zhang Q. [1 ]
Chen Y. [1 ]
Liu Q. [1 ]
Shan Q. [1 ,2 ]
机构
[1] Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu
[2] Department of Cardiovascular Medicine, The First Affiliated Hospital of Nanjing Medical University, Guangzhou road 300, Nanjing, 210029, Jiangsu Province
基金
中国国家自然科学基金;
关键词
Angiotensin receptor; Angiotensin-converting enzyme inhibitors; Antagonists; Heart failure with preserved ejection fraction; Mineralocorticoid-receptor antagonists;
D O I
10.1007/s00059-015-4346-8
中图分类号
学科分类号
摘要
Aim: The purpose of this meta-analysis was to evaluate the effects of renin–angiotensin–aldosterone system (RAAS) inhibitors on mortality, hospitalization, diastolic function, and exercise capacity in heart failure with preserved ejection fraction (HFpEF). Methods: Thirteen randomized controlled trials (RCTs), totaling 12,532 patients with HFpEF, were selected. All-cause and cardiovascular mortality, all-cause and heart failure-related hospitalization, diastolic function, and the 6-min walk distance were assessed. The risk ratios (RR) of the dichotomous data, weighted mean difference (WMD) of continuous data, and 95 % confidence intervals (CI) were calculated to assess the effects of RAAS inhibitors. Results: RAAS inhibitors significantly decreased heart failure-related hospitalization (RR 0.89; 95 % CI 0.82–0.97; p = 0.01) and improved the diastolic function, as reflected in a reduced E/e’ index (MD −1.38; 95 % CI −2.01 to −0.74; p < 0.0001). However, there were no beneficial effects on all-cause cardiovascular mortality and all-cause hospitalization. Other diastolic parameters had few changes compared with the controls. The 6-min walk distance was not improved by the use of RAAS inhibitors. Conclusion: In patients with HFpEF, RAAS inhibitors decreased heart-failure hospitalization and the E/e’ index without affecting mortality, all-cause hospitalization, other diastolic function parameters, and the 6-min walk distance. © 2015, Urban & Vogel.
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页码:76 / 86
页数:10
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