Relative Efficacy of Spironolactone, Eplerenone, and cAnRenone in patients with Chronic Heart failure (RESEARCH): a systematic review and network meta-analysis of randomized controlled trials

This study aims to assess the comparative benefit and risk profile of treatment with mineralocorticoid receptor antagonists (MRAs) with regard to all-cause mortality (primary endpoint), cardiovascular mortality, or heart failure (HF) –related hospitalization (secondary endpoints) and the safety endpoints hyperkalemia, acute renal failure, and gynecomastia in patients with chronic HF. We conducted a systematic review and network meta-analysis following PRISMA-P and PRISMA-NMA guidelines. From 16 different sources, 14 randomized controlled trials totaling 12,213 patients testing an active treatment of either spironolactone, eplerenone, or canrenone/potassium-canreonate in adults with symptomatic HF due to systolic dysfunction reporting any of the above endpoints were retained. Efficacy in comparison to placebo/standard med ical care with respect to all-cause mortality was confirmed for spironolactone and eplerenone while no conclusion could be drawn for canrenone (HR 0.69 (0.62; 0.77), 0.82 (0.75; 0.91), and 0.50 (0.17; 1.45), respectively). Indirect comparisons hint a potential (non-significant) preference of spirono lactone over eplerenone (HR 0.84 (0.68; 1.03)). The overall risk of bias was low to intermediate. Results for secondary endpoints as well as sensitivity analyses essentially mirrored these findings. The beta-blocker adjusted meta-analysis for the primary endpoint showed the same tendency as the unad justed one (HR 0.39 (0.07; 2.03)). Results need to be inter...
Source: Heart Failure Reviews - Category: Cardiology Source Type: research

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Authors: Alanagreh L, Alzoughool F, Atoum M Abstract The emerging COVID-19 pandemic poses a threat to the global health care system. Given the lack of antiviral therapies or vaccines for the disease, the antimalarial drug hydroxychloroquine (HCQ) obtained much attention as a treatment for COVID-19. However, there are limited and uncertain clinical data to support the beneficial effect of this drug in COVID-19 treatment. HCQ has several side effects and warnings, including blindness, heart failure, and renal toxicity, even with recommended doses. For severe cases of COVID-19 or in patients with preexisting condition...
Source: International Journal of Risk and Safety in Medicine - Category: Drugs & Pharmacology Tags: Int J Risk Saf Med Source Type: research
Publication date: Available online 2 June 2020Source: Nutrition, Metabolism and Cardiovascular DiseasesAuthor(s): Azadeh Shafieesabet, Nadja Scherbakov, Nicole Ebner, Anja Sandek, Stefanie Fuhrmann, Stephan von Haehling, Stefan D. Ankera, Mitja Lainscak, Ulrich Laufs, Wolfram Doehner
Source: Nutrition, Metabolism and Cardiovascular Diseases - Category: Nutrition Source Type: research
Publication date: Available online 1 June 2020Source: Canadian Journal of CardiologyAuthor(s): Réda Jakamy, Pierre-Emmanuel Séguéla, Zakaria Jalal, Maxime de Guillebon, Jean-Benoit Thambo
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Publication date: Available online 1 June 2020Source: Journal of Chemical NeuroanatomyAuthor(s): Farnaz Nikbakht, Ali Mohammad Khanizadeh, Fereshteh Golab, Tourandokht Baluchnejadmojarad, Somayeh Vazifehkhah, Alireza Moeinsadat
Source: Journal of Chemical Neuroanatomy - Category: Neuroscience Source Type: research
Exercise is known to improve outcomes in heart failure patients, but there is a limit as to the data that can be obtained on mechanisms of action from human patients. Here researchers use a mouse model of heart failure to show that exercise doesn't impact the harmful presence of fibrosis in heart tissue, but does increase capillary density. The density of capillaries in tissues throughout the body declines with age, and this progressive loss is probably quite important in a number of aspects of aging, particularly in tissues that have high energy demands, such as the heart. That fibrosis isn't affected suggests that exerci...
Source: Fight Aging! - Category: Research Authors: Tags: Daily News Source Type: blogs
Sometimes when the discussion of tackling the novel coronavirus comes up, the use of medical devices gets lost in the shuffle. Most of the conversation surrounding COVID-19 comes from either the promise of a vaccine or the expansion of tests. Abiomed is adding to the conversation surrounding medtech’s potential contribution to the treatment of COVID-19 patients. Monday, the Danvers, MA-based company by receiving Emergency Use Authorization for a device to treat COVID-19 related right heart failure patients. The Impella RP is a temporary heart pump that provides circulatory support for patients who develop...
Source: MDDI - Category: Medical Devices Authors: Tags: Cardiovascular COVID-19 Source Type: news
Resumo A doen ça de coronavírus 2019 (COVID-19) é uma pandemia global afetando o mundo, estando presente em mais de 1.300.000 pacientes. O COVID-19 age pelo receptor da enzima conversora de angiotensina 2 (ECA2). As comorbidades cardiovasculares são mais frequentes com COVID-19, e cerca 10% de casos desenvolv em miocardite (22% de pacientes críticas). Mais pesquisas serão necessárias para continuar ou descontinuar inibidores de ECA e bloqueadores dos receptores da angiotensina, que são essenciais para hipertensão e insuficiência cardíaca em COVID-1...
Source: Arquivos Brasileiros de Cardiologia - Category: Cardiology Source Type: research
AbstractPurpose of the ReviewAlthough still a relatively new technology, long-term left ventricular assist devices (LVADs) for management of advanced heart failure is rapidly increasing. Initially designed as a bridge to transplant, these invasive devices are increasingly used as a destination therapy, creating unique and long-term infection risks. The aim of this comprehensive review is to highlight current evidence about the prevention, diagnosis, and management of LVAD-specific infections.Recent FindingsThere are two recent, major societal guidelines (The International Society for Heart and Lung Transplantation, 2017, a...
Source: Current Infectious Disease Reports - Category: Infectious Diseases Source Type: research
AbstractPurpose of ReviewAlthough the utilization of mechanical circulatory support (MCS) devices is increasing, ethical dilemmas regarding device deactivation and dying process persist, potentially complicating delivery of optimal and compassionate care at end-of-life (EOL). This review aims to study EOL challenges, left ventricular assist devices (LVADs) as a nuanced life support treatment, legal history in the US impacting EOL care, and suggestions to improve EOL care for patients on MCS support.Recent FindingsRecent studies have demonstrated challenging aspects of EOL care for patients on LVAD support: low use of advan...
Source: Current Heart Failure Reports - Category: Cardiology Source Type: research
We analyzed cytotoxicity of water-soluble potassium salts of (+)- and (-) usnic acid (UA) for ciliatesP. caudatum. The median lethal concentrations for (+)- and (-) enantiomers did not significantly differ and were 7.5 ±0.5 and 6.7±0.4, respectively. In a concentration of 8 μM, (+)-UA and (-)-UA salts increased the content of TBA-reactive products, which indicates the formation of oxidative stress under the action of high UA concentrations. In the presence of (+)-UA and (-)-UA salts in a concentration range fro m 2 to 8 μM, the number of food vacuoles in ciliates decreased, which attested to a decrease ...
Source: Bulletin of Experimental Biology and Medicine - Category: Biology Source Type: research
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