Evidence mapPaperPMID 39877019Full record

SynthesisFrontiers in cardiovascular medicine2024

Comparative efficacy of different drugs in acute heart failure with renal dysfunction: a systematic review and network meta-analysis.

Qianyu Lv, Qian Wu, Yingtian Yang, Lanlan Li, Xuejiao Ye, Shihan Wang, Yanfei Lv, Manshi Wang, Yushan Li

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in cardiovascular medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Qianyu Lv *Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Qian Wu *Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Yingtian YangGuang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Lanlan LiGuang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Xuejiao YeGuang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Shihan WangGuang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Yanfei LvSchool of Management, Fudan University, Shanghai, China.
Manshi WangEmergency Department, Guangwai Hospital, Beijing, China.
Yushan LiInstitute of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: This network meta-analysis was to compare the efficacy of different drugs on cardiac function, renal function, and clinical outcomes in patients with acute heart failure (AHF) accompanied by renal dysfunction. Methods: PubMed, EMBASE, Cochrane Library, and Web of Science were searched to screen all clinical trials of AHF between January 1st 2001 and March 31th 2024. The primary outcome measures were N-terminal pro-B type natriuretic peptide (NT-proBNP), B-type natriuretic peptide (BNP), glomerular filtration rate (GFR), blood urea nitrogen, serum creatinine, all-cause mortality within 60 days, and cardiovascular mortality. Results: After screening 30,697 citations, 13 studies (21,745 patients) were included, and drugs including nesiritide, dopamine, tolvaptan, levosimendan, dobutamine, furosemide, and spirolactone, and high dose of diuretics (HDD, furosemide, and spirolactone) were estimated. The results indicated that HDD had the best efficacy in reducing NT-proBNP levels. In detail, HDD notably reduced NT-proBNP levels compared to conventional treatment or placebo (PLC) [MD = -950.24; 95% CrI (-1,832.21, -64.12)]. Levosimendan significantly increased GFR levels compared to PLC [MD = 14.46; 95% CrI (3.88, 25.97)] and tolvaptan [MD = 13.83; 95% CrI (2.31, 25.33)]. No significant difference was found in 60-day all-cause mortality and cardiovascular mortality across drugs. Conclusion: HDD showed the best efficacy in reducing NT-proBNP levels compared with dopamine and nesiritide, and levosimendan could significantly improve GFR levels, with no marked difference in the effect of various drugs on 60-day all-cause mortality. Hence, HDD and levosimendan may be optimal agents in the treatment of AHF with renal dysfunction. Systematic Review Registration: PROSPERO, identifier (CRD42023454616).

Indexed as

acute heart failurediureticshigh dose of diureticsnetwork meta-analysisrenal insufficiency

Identifiers

PMID39877019
PMCPMC11772403

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.