Aliskiren for heart failure: a systematic review and meta-analysis of randomized controlled trials
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Hongzhi Liu1, Hongxing Luo1, Suqin Wang1, Cong Zhang1, Jialiang Hao1 and Chuanyu Gao1
1Department of Cardiology, Zhengzhou University People’s Hospital, Zhengzhou, Henan, 450003, China
Hongxing Luo, email: [email protected]
Keywords: aliskiren, heart failure, mortality, meta-analysis, systematic review
Received: June 05, 2017 Accepted: September 03, 2017 Published: September 21, 2017
Objective: To systematically review and synthesize the currently available evidence of aliskiren for the treatment of heart failure.
Materials and Methods: We systematically searched the Cochrane, Embase and PubMed databases to identify the randomized controlled trials (RCT) on the effects of aliskiren on heart failure. Data were synthesized with random effects model and presented in forest plot. Publication bias was evaluated with funnel plot. Heterogeneity was evaluated with Begg’s test and Egger’s test.
Results: Of 124 studies, 6 RCT of 9845 heart failure patients were included for meta-analysis, including 3727 patients receiving aliskiren. Compared with the controls, aliskiren did not significantly reduce the all-cause mortality (1.02 [0.91–1.14], I2 = 0%) or cardiovascular mortality (1.02 [0.88–1.17], I2 = 7.3%) of heart failure patients. Total adverse events, renal dysfunction, hypotension and hyperkalaemia were not significantly different between the aliskiren group and control group. Begg’s test and Egger’s test indicated low heterogeneity. Funnel plots indicated low publication bias.
Conclusions: Aliskiren, either used alone or combined with standard medical therapy, does not significantly reduce the all-cause mortality or cardiovascular mortality of heart failure patients. Although aliskiren does not cause statistically higher adverse events, its adverse events may not be neglected.
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