PMID- 23088367
OWN - NLM
STAT- MEDLINE
DCOM- 20131001
LR  - 20211021
IS  - 1365-2125 (Electronic)
IS  - 0306-5251 (Print)
IS  - 0306-5251 (Linking)
VI  - 75
IP  - 5
DP  - 2013 May
TI  - Additional use of an aldosterone antagonist in patients with mild to moderate 
      chronic heart failure: a systematic review and meta-analysis.
PG  - 1202-12
LID - 10.1111/bcp.12012 [doi]
AB  - AIMS: Aldosterone antagonists (AldoAs) have been used to treat severe chronic 
      heart failure (CHF). There is uncertainty regarding the efficacy of using AldoAs 
      in mild to moderate CHF with New York Heart Association (NYHA) classifications of 
      I to II. This study summarizes the evidence for the efficacy of spironolactone 
      (SP), eplerenone (EP) and canrenone in mild to moderate CHF patients. METHODS: 
      PubMed, MEDLINE, EMBASE and OVID databases were searched before June 2012 for 
      randomized and quasi-randomized controlled trials assessing AldoA treatment in 
      CHF patients with NYHA classes I to II. Data concerning the study's design, 
      patients' characteristics and outcomes were extracted. Risk ratio (RR) and 
      weighted mean differences (WMD) or standardized mean difference were calculated 
      using either fixed or random effects models. RESULTS: Eight trials involving 3929 
      CHF patients were included. AldoAs were superior to the control in all cause 
      mortality (RR 0.79, 95% CI 0.66, 0.95) and in re-hospitalization for cardiac 
      causes (RR 0.62, 95% CI 0.52, 0.74), the left ventricular ejection fraction was 
      improved by AldoA treatment (WMD 2.94%, P = 0.52). Moreover, AldoA therapy 
      decreased the left ventricular end-diastolic volume (WMD -14.04 ml, P < 0.00001), 
      the left ventricular end-systolic volume (WMD -14.09 ml, P < 0.00001). A 
      stratified analysis showed a statistical superiority in the benefits of SP over 
      EP in reducing LVEDV and LVESV. AldoAs reduced B-type natriuretic peptide 
      concentrations (WMD -37.76 pg ml(-1), P < 0.00001), increased serum creatinine 
      (WMD 8.69 mumol l(-1), P = 0.0003) and occurrence of hyperkalaemia (RR 1.78, 95% 
      CI 1.43, 2.23). CONCLUSIONS: Additional use of AldoAs in CHF patients may 
      decrease mortality and re-hospitalization for cardiac reasons, improve cardiac 
      function and simultaneously ameliorate LV reverse remodelling.
CI  - (c) 2012 The Authors. British Journal of Clinical Pharmacology (c) 2012 The British 
      Pharmacological Society.
FAU - Hu, Li-jun
AU  - Hu LJ
AD  - Department of cardiology, Second Affiliated Hospital, Chongqing Medical 
      University, Chongqing, China.
FAU - Chen, Yun-qing
AU  - Chen YQ
FAU - Deng, Song-bai
AU  - Deng SB
FAU - Du, Jian-lin
AU  - Du JL
FAU - She, Qiang
AU  - She Q
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
PL  - England
TA  - Br J Clin Pharmacol
JT  - British journal of clinical pharmacology
JID - 7503323
RN  - 0 (Mineralocorticoid Receptor Antagonists)
RN  - 27O7W4T232 (Spironolactone)
RN  - 6995V82D0B (Eplerenone)
RN  - 78O20X9J0U (Canrenone)
SB  - IM
MH  - Canrenone/therapeutic use
MH  - Chronic Disease
MH  - Eplerenone
MH  - Heart Failure/*drug therapy/physiopathology
MH  - Humans
MH  - Mineralocorticoid Receptor Antagonists/*therapeutic use
MH  - Randomized Controlled Trials as Topic
MH  - Severity of Illness Index
MH  - Spironolactone/analogs & derivatives/therapeutic use
MH  - Ventricular Remodeling/*drug effects
PMC - PMC3635590
EDAT- 2012/10/24 06:00
MHDA- 2013/10/18 06:00
PMCR- 2014/05/01
CRDT- 2012/10/24 06:00
PHST- 2012/08/14 00:00 [received]
PHST- 2012/10/16 00:00 [accepted]
PHST- 2012/10/24 06:00 [entrez]
PHST- 2012/10/24 06:00 [pubmed]
PHST- 2013/10/18 06:00 [medline]
PHST- 2014/05/01 00:00 [pmc-release]
AID - 10.1111/bcp.12012 [doi]
PST - ppublish
SO  - Br J Clin Pharmacol. 2013 May;75(5):1202-12. doi: 10.1111/bcp.12012.