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Cerebrolysin for acute ischaemic stroke.
CONCLUSIONS: Moderate-quality evidence indicates that Cerebrolysin probably has little or no beneficial effect on preventing all-cause death in acute ischaemic stroke, or on the total number of people with serious adverse events. Moderate-quality evidence also indicates a potential increase in non-fatal serious adverse events with Cerebrolysin use. PMID: 32662068 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - July 13, 2020 Category: General Medicine Authors: Ziganshina LE, Abakumova T, Hoyle CH Tags: Cochrane Database Syst Rev Source Type: research

First-line drugs inhibiting the renin angiotensin system versus other first-line antihypertensive drug classes for hypertension.
CONCLUSIONS: We found predominantly moderate quality evidence that all-cause mortality is similar when first-line RAS inhibitors are compared to other first-line antihypertensive agents. First-line thiazides caused less HF and stroke than first-line RAS inhibitors. The quality of the evidence comparing first-line beta-blockers and first-line RAS inhibitors was low and the lower risk of total CV events and stroke seen with RAS inhibitors may change with the publication of additional trials. Compared with first-line CCBs, first-line RAS inhibitors reduced HF but increased stroke. The magnitude of the reduction in HF exceeded...
Source: Cochrane Database of Systematic Reviews - January 11, 2015 Category: Journals (General) Authors: Xue H, Lu Z, Tang WL, Pang LW, Wang GM, Wong GW, Wright JM Tags: Cochrane Database Syst Rev Source Type: research

Dipeptidyl peptidase-4 inhibitors, glucagon-like peptide 1 receptor agonists and sodium-glucose co-transporter-2 inhibitors for people with cardiovascular disease: a network meta-analysis
CONCLUSIONS: Findings from both standard and network meta-analyses of moderate- to high-certainty evidence suggest that GLP-1RA and SGLT2i are likely to reduce the risk of CVD mortality and all-cause mortality in people with established CVD; high-certainty evidence demonstrates that treatment with SGLT2i reduce the risk of hospitalisation for HF, while moderate-certainty evidence likely supports the use of GLP-1RA to reduce fatal and non-fatal stroke. Future studies conducted in the non-diabetic CVD population will reveal the mechanisms behind how these agents improve clinical outcomes irrespective of their glucose-lowerin...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Takayoshi Kanie Atsushi Mizuno Yoshimitsu Takaoka Takahiro Suzuki Daisuke Yoneoka Yuri Nishikawa Wilson Wai San Tam Jakub Morze Andrzej Rynkiewicz Yiqiao Xin Olivia Wu Rui Providencia Joey Sw Kwong Source Type: research

Alpha-2 adrenergic agonists for the prevention of cardiac complications among adults undergoing surgery.
CONCLUSIONS: Our review concludes that prophylactic α-2 adrenergic agonists generally do not prevent perioperative death or major cardiac complications. For non-cardiac surgery, there is moderate-to-high quality evidence that these agents do not prevent death, myocardial infarction or stroke. Conversely, there is moderate quality evidence that these agents have important adverse effects, namely increased risks of hypotension and bradycardia. For cardiac surgery, there is moderate quality evidence that α-2 adrenergic agonists have no effect on the risk of mortality or myocardial infarction, and that they increase the risk...
Source: Cochrane Database of Systematic Reviews - March 6, 2018 Category: General Medicine Authors: Duncan D, Sankar A, Beattie WS, Wijeysundera DN Tags: Cochrane Database Syst Rev Source Type: research

Anticoagulation versus placebo for heart failure in sinus rhythm
CONCLUSIONS: Based on the three RCTs, there is no evidence that oral anticoagulant therapy modifies mortality in people with HF in sinus rhythm. The evidence is uncertain if warfarin has any effect on all-cause death compared to placebo or no treatment, but it may increase the risk of major bleeding events. There is no evidence of a difference in the effect of rivaroxaban on all-cause death compared to placebo. It probably reduces the risk of stroke, but probably increases the risk of major bleedings. The available evidence does not support the routine use of anticoagulation in people with HF who remain in sinus rhythm.PMI...
Source: Cochrane Database of Systematic Reviews - May 18, 2021 Category: General Medicine Authors: Eduard Shantsila Monika Kozie ł Gregory Yh Lip Source Type: research

First-line diuretics versus other classes of antihypertensive drugs for hypertension
CONCLUSIONS: When used as first-line agents for the treatment of hypertension, thiazides and thiazide-like drugs likely do not change total mortality and likely decrease some morbidity outcomes such as cardiovascular events and withdrawals due to adverse effects, when compared to beta-blockers, calcium channel blockers, ACE inhibitors, and alpha-blockers.PMID:37439548 | DOI:10.1002/14651858.CD008161.pub3
Source: Cochrane Database of Systematic Reviews - July 13, 2023 Category: General Medicine Authors: Marcia Reinhart Lorri Puil Douglas M Salzwedel James M Wright Source Type: research

WITHDRAWN: Antiplatelet agents versus control or anticoagulation for heart failure in sinus rhythm.
CONCLUSIONS: At present there is little evidence from long term RCTs to recommend the use of antiplatelet therapy to prevent thromboembolism in patients with heart failure in sinus rhythm. A possible interaction with ACE inhibitors may reduce the efficacy of aspirin, although this evidence is mainly from retrospective analyses of trial cohorts and two RCTs. There is also no current evidence to support the use of oral anticoagulation (when compared to aspirin/clopidogrel) in patients with heart failure in sinus rhythm. Anticoagulation/antiplatelet therapy should be reserved for heart failure patients with other comorbiditie...
Source: Cochrane Database of Systematic Reviews - May 2, 2016 Category: Journals (General) Authors: Lip GY, Wrigley BJ, Pisters R Tags: Cochrane Database Syst Rev Source Type: research

Homocysteine-lowering interventions for preventing cardiovascular events.
CONCLUSIONS: This updated Cochrane review found no evidence to suggest that homocysteine-lowering interventions in the form of supplements of vitamins B6, B9 or B12 given alone or in combination should be used for preventing cardiovascular events. Furthermore, there is no evidence suggesting that homocysteine-lowering interventions are associated with an increased risk of cancer. PMID: 23440809 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - March 2, 2013 Category: Journals (General) Authors: Martí-Carvajal AJ, Solà I, Lathyris D, Karakitsiou DE, Simancas-Racines D Tags: Cochrane Database Syst Rev Source Type: research

Blood pressure targets for hypertension in people with diabetes mellitus.
CONCLUSIONS: At the present time, evidence from randomized trials does not support blood pressure targets lower than the standard targets in people with elevated blood pressure and diabetes. More randomized controlled trials are needed, with future trials reporting total mortality, total serious adverse events as well as cardiovascular and renal events. PMID: 24170669 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - November 2, 2013 Category: Journals (General) Authors: Arguedas JA, Leiva V, Wright JM Tags: Cochrane Database Syst Rev Source Type: research

Statins for acute coronary syndrome.
CONCLUSIONS: Based on moderate quality evidence, due to concerns about risk of bias and imprecision, initiation of statin therapy within 14 days following ACS does not reduce death, myocardial infarction, or stroke up to four months, but reduces the occurrence of unstable angina at four months following ACS. Serious side effects were rare. PMID: 25178118 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - September 1, 2014 Category: Journals (General) Authors: Vale N, Nordmann AJ, Schwartz GG, de Lemos J, Colivicchi F, den Hartog F, Ostadal P, Macin SM, Liem AH, Mills EJ, Bhatnagar N, Bucher HC, Briel M Tags: Cochrane Database Syst Rev Source Type: research

Perioperative beta-blockers for preventing surgery-related mortality and morbidity.
CONCLUSIONS: According to our findings, perioperative application of beta-blockers still plays a pivotal role in cardiac surgery , as they can substantially reduce the high burden of supraventricular and ventricular arrhythmias in the aftermath of surgery. Their influence on mortality, AMI, stroke, congestive heart failure, hypotension and bradycardia in this setting remains unclear.In non-cardiac surgery, evidence from low risk of bias trials shows an increase in all-cause mortality and stroke with the use of beta-blockers. As the quality of evidence is still low to moderate, more evidence is needed before a definitive co...
Source: Cochrane Database of Systematic Reviews - September 18, 2014 Category: Journals (General) Authors: Blessberger H, Kammler J, Domanovits H, Schlager O, Wildner B, Azar D, Schillinger M, Wiesbauer F, Steinwender C Tags: Cochrane Database Syst Rev Source Type: research

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