Evidence map›Paper›PMID 41711224›Full record

SynthesisESC heart failure2026

Cardiovascular risk associated with polypharmacy in heart failure: a systematic review and meta-analysis.

Jane J Lee, Minseo Kim, Gerald Chi, Sunny Kumar

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in ESC heart failure, 2026. 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

4 authors.

Jane J LeeDepartment of Food and Nutrition, Sookmyung Women's University, 100 Cheongpa-ro 47-gil, Yongsan-gu, Seoul 04310, Republic of Korea.ORCID 0000-0002-6276-7667
Minseo KimDepartment of Food and Nutrition, Sookmyung Women's University, 100 Cheongpa-ro 47-gil, Yongsan-gu, Seoul 04310, Republic of Korea.ORCID 0000-0002-3116-9779
Gerald ChiDivision of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.ORCID 0000-0002-8371-1689
Sunny KumarDivision of Cardiovascular Disease, UHS Wilson Medical Center, Johnson City, NY, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Polypharmacy is highly prevalent among patients with heart failure (HF), due to multimorbidity and guideline-directed pharmacotherapy. While polypharmacy aims to optimize management, it can increase the risk of drug-drug interactions and adverse drug events, which may compromise clinical outcomes. However, the evidence regarding the relationship between polypharmacy and cardiovascular (CV) outcomes in HF populations remains limited. The aim of this study was to determine the association between polypharmacy and adverse CV outcomes among patients with HF. A systematic review and meta-analysis were conducted to evaluate the association between polypharmacy and adverse CV outcomes in HF. Relevant studies were identified through searches of PubMed, Embase, and Web of Science. The primary outcomes included a composite CV endpoint and its individual components. Effect estimates, based on comparisons between the highest and lowest levels of polypharmacy, were pooled using random-effects models. Ten studies including 30 115 patients with HF were analyzed. Compared with those without polypharmacy, patients with polypharmacy had a significantly increased risk of the composite CV endpoint (HR: 1.27; 95% CI: 1.15-1.39). Notably, polypharmacy was linked to a higher risk of HF hospitalization (HR: 1.42; 95% CI: 1.28-1.56). No significant associations were found for CV death (HR: 1.07; 95% CI: 0.81-1.41) or all-cause mortality (HR: 1.05; 95% CI: 0.88-1.25). Polypharmacy in patients with HF was associated with increased risk of composite CV outcome and HF hospitalization, reflecting the complexity of managing multiple medications. These findings underscore the need for individualized medication reviews to minimize inappropriate prescribing and ensure continued delivery of evidence-based therapies. PROSPERO Registration Number CRD420251110556.

Indexed as

Heart FailurePolypharmacyHumansRisk AssessmentRisk FactorsCardiovascular outcomesHeart failureMeta-analysisMortalityPolypharmacySystematic review

Identifiers

PMID41711224
PMCPMC13070473

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.