Xinyu Tong, Lijuan Shen, Xiaomin Zhou, Yudan Wang, Sheng Chang, Shu Lu
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引用次数: 0
Abstract
Background and objective: At present, the therapies of dilated cardiomyopathy concentrated on the symptoms of heart failure and related complications. The study is to evaluate the clinical efficacy of a combination of various conventional and adjuvant drugs in treating dilated cardiomyopathy via network meta-analysis.
Methods: The study was reported according to the PRISMA 2020 statement. From inception through 27 June 2022, the PubMed, Embase, Cochrane library, and Web of Science databases were searched for randomized controlled trials on medicines for treating dilated cardiomyopathy. The quality of the included studies was evaluated according to the Cochrane risk of bias assessment. R4.1.3 and Revman5.3 software were used for analysis.
Results: There were 52 randomized controlled trials in this study, with a total of 25 medications and a sample size of 3048 cases. The network meta-analysis found that carvedilol, verapamil, and trimetazidine were the top three medicines for improving left ventricular ejection fraction (LVEF). Ivabradine, bucindolol, and verapamil were the top 3 drugs for improving left ventricular end-diastolic dimension (LVEDD). Ivabradine, L-thyroxine, and atorvastatin were the top 3 drugs for improving left ventricular end-systolic dimension (LVESD). Trimetazidine, pentoxifylline, and bucindolol were the top 3 drugs for improving the New York Heart Association classification (NYHA) cardiac function score. Ivabradine, carvedilol, and bucindolol were the top 3 drugs for reducing heart rate (HR).
Conclusion: A combination of different medications and conventional therapy may increase the clinical effectiveness of treating dilated cardiomyopathy. Beta-blockers, especially carvedilol, can improve ventricular remodeling, cardiac function, and clinical efficacy in patients with dilated cardiomyopathy (DCM). Hence, they can be used if patients tolerate them. If LVEF and HR do not meet the standard, ivabradine can also be used in combination with other treatments. However, since the quality and number of studies in our research were limited, large sample size, multi-center, and high-quality randomized controlled trials are required to corroborate our findings.
背景与目的:目前，扩张型心肌病的治疗主要集中在心衰症状及相关并发症。本研究通过网络meta分析，评价多种常规及辅助药物联合治疗扩张型心肌病的临床疗效。方法:本研究按照PRISMA 2020声明进行报道。从成立到2022年6月27日，检索了PubMed、Embase、Cochrane图书馆和Web of Science数据库，寻找治疗扩张型心肌病药物的随机对照试验。根据Cochrane偏倚风险评估对纳入研究的质量进行评价。采用R4.1.3和Revman5.3软件进行分析。结果:本研究共纳入52项随机对照试验，共纳入25种药物，样本量3048例。网络荟萃分析发现，卡维地洛、维拉帕米和曲美他嗪是改善左心室射血分数(LVEF)的前三种药物。伊伐布雷定、布辛多洛和维拉帕米是改善左室舒张末期尺寸(LVEDD)的前3位药物。伊伐布雷定、l -甲状腺素和阿托伐他汀是改善左心室收缩末期尺寸(LVESD)的前3位药物。曲美他嗪、己酮茶碱和布钦多洛尔是改善纽约心脏协会心功能评分前3位的药物。伊伐布雷定、卡维地洛和布辛多洛是降低心率(HR)的前3位药物。结论:不同药物联合常规治疗可提高扩张型心肌病的临床疗效。-受体阻滞剂，尤其是卡维地洛，可以改善扩张型心肌病(DCM)患者的心室重构、心功能和临床疗效。因此，如果患者能够耐受，就可以使用这些药物。如果LVEF和HR不符合标准，也可以与其他治疗联合使用伊伐布雷定。然而，由于本研究的研究质量和数量有限，需要大样本量、多中心、高质量的随机对照试验来证实我们的发现。
期刊介绍：
Drugs in R&D is an international, peer reviewed, open access, online only journal, and provides timely information from all phases of drug research and development that will inform clinical practice. Healthcare decision makers are thus provided with knowledge about the developing place of a drug in therapy.
The Journal includes:
Clinical research on new and established drugs;
Preclinical research of direct relevance to clinical drug development;
Short communications and case study reports that meet the above criteria will also be considered;
Reviews may also be considered.
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