{"title":"静脉注射尼可地尔治疗急性失代偿性心力衰竭患者:一项随机对照试验的荟萃分析。","authors":"Yan Zhu, Shanshan Xie","doi":"10.1080/14017431.2023.2220556","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Pilot studies have suggested the potential benefits of intravenous nicorandil for patients with acute decompensated heart failure (ADHF). However, clinical evidence remains limited. The aim of the study was to summarize the efficacy and safety of intravenous nicorandil for the treatment of ADHF.</p><p><strong>Design: </strong>A systematic review and meta-analysis was performed. The search for relevant randomised controlled trials (RCTs) was conducted in PubMed, Embase, Cochrane's Library, Wanfang, and CNKI databases. A random-effects model was employed to combine the results.</p><p><strong>Results: </strong>Eight RCTs contributed to the meta-analysis. Pooled results showed that acute treatment with intravenous nicorandil could significantly improve the symptom of dyspnea at 24 h after treatment, as evidenced by the five-point Likert scale for dyspnea after treatment (mean difference [MD]: -0.26, 95% confidence interval [CI]: -0.40 to -0.13, <i>p</i> < 0.001). Furthermore, nicorandil significantly reduced serum B natriuretic peptide (MD: -30.03 ng/dl, 95% CI: -47.00 to -13.06, <i>p</i> < 0.001), and N-terminal proBNP (MD: -138.69, 95% CI: -248.06 to -29.31, <i>p</i> = 0.01). In addition, nicorandil significantly improved ultrasonic parameters including left ventricular ejection fraction and E/e' at discharge. Moreover, during the follow-up duration of up to 90 days, intravenous nicorandil significantly reduced the incidence of major adverse cardiovascular events (risk ratio [RR]: 0.55, 95% CI: 0.32 to 0.93, <i>p</i> = 0.03). The incidence of treatment-related adverse events was not significantly different between nicorandil and controls (RR: 1.22, 95% CI: 0.69 to 2.15, <i>p</i> = 0.49).</p><p><strong>Conclusions: </strong>Results of this study suggest that intravenous nicorandil may be an effective and safe treatment for patients with ADHF.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":"57 1","pages":"2220556"},"PeriodicalIF":1.0000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Intravenous nicorandil for patients with acute decompensated heart failure: a meta-analysis of randomized controlled trials.\",\"authors\":\"Yan Zhu, Shanshan Xie\",\"doi\":\"10.1080/14017431.2023.2220556\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Pilot studies have suggested the potential benefits of intravenous nicorandil for patients with acute decompensated heart failure (ADHF). However, clinical evidence remains limited. The aim of the study was to summarize the efficacy and safety of intravenous nicorandil for the treatment of ADHF.</p><p><strong>Design: </strong>A systematic review and meta-analysis was performed. The search for relevant randomised controlled trials (RCTs) was conducted in PubMed, Embase, Cochrane's Library, Wanfang, and CNKI databases. A random-effects model was employed to combine the results.</p><p><strong>Results: </strong>Eight RCTs contributed to the meta-analysis. Pooled results showed that acute treatment with intravenous nicorandil could significantly improve the symptom of dyspnea at 24 h after treatment, as evidenced by the five-point Likert scale for dyspnea after treatment (mean difference [MD]: -0.26, 95% confidence interval [CI]: -0.40 to -0.13, <i>p</i> < 0.001). Furthermore, nicorandil significantly reduced serum B natriuretic peptide (MD: -30.03 ng/dl, 95% CI: -47.00 to -13.06, <i>p</i> < 0.001), and N-terminal proBNP (MD: -138.69, 95% CI: -248.06 to -29.31, <i>p</i> = 0.01). In addition, nicorandil significantly improved ultrasonic parameters including left ventricular ejection fraction and E/e' at discharge. Moreover, during the follow-up duration of up to 90 days, intravenous nicorandil significantly reduced the incidence of major adverse cardiovascular events (risk ratio [RR]: 0.55, 95% CI: 0.32 to 0.93, <i>p</i> = 0.03). The incidence of treatment-related adverse events was not significantly different between nicorandil and controls (RR: 1.22, 95% CI: 0.69 to 2.15, <i>p</i> = 0.49).</p><p><strong>Conclusions: </strong>Results of this study suggest that intravenous nicorandil may be an effective and safe treatment for patients with ADHF.</p>\",\"PeriodicalId\":21383,\"journal\":{\"name\":\"Scandinavian Cardiovascular Journal\",\"volume\":\"57 1\",\"pages\":\"2220556\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2023-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Scandinavian Cardiovascular Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/14017431.2023.2220556\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Scandinavian Cardiovascular Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/14017431.2023.2220556","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
目的:初步研究表明静脉注射尼可地尔对急性失代偿性心力衰竭(ADHF)患者的潜在益处。然而,临床证据仍然有限。本研究的目的是总结静脉注射尼可地尔治疗ADHF的疗效和安全性。设计:进行系统回顾和荟萃分析。在PubMed、Embase、Cochrane’s Library、Wanfang和CNKI数据库中搜索相关的随机对照试验(RCT)。采用随机效应模型对结果进行组合。结果:8项随机对照试验参与了荟萃分析。汇总结果显示,静脉注射尼可地尔急性治疗可显著改善24岁时的呼吸困难症状 治疗后h,如治疗后呼吸困难的Likert五点量表所示(平均差异[MD]:-0.26,95%置信区间[CI]:-0.40至-0.13,p p p = 0.01)。此外,尼可地尔显著改善了包括左心室射血分数和出院时E/E’在内的超声参数。此外,在长达90的随访期间 天,静脉注射尼可地尔显著降低了主要心血管不良事件的发生率(风险比[RR]:0.55,95%CI:0.32至0.93,p = 治疗相关不良事件的发生率在尼可地尔和对照组之间没有显著差异(RR:1.22,95%CI:0.69~2.15,p = 0.49)。结论:本研究结果表明,静脉注射尼可地尔可能是治疗ADHF患者的有效和安全的方法。
Intravenous nicorandil for patients with acute decompensated heart failure: a meta-analysis of randomized controlled trials.
Objectives: Pilot studies have suggested the potential benefits of intravenous nicorandil for patients with acute decompensated heart failure (ADHF). However, clinical evidence remains limited. The aim of the study was to summarize the efficacy and safety of intravenous nicorandil for the treatment of ADHF.
Design: A systematic review and meta-analysis was performed. The search for relevant randomised controlled trials (RCTs) was conducted in PubMed, Embase, Cochrane's Library, Wanfang, and CNKI databases. A random-effects model was employed to combine the results.
Results: Eight RCTs contributed to the meta-analysis. Pooled results showed that acute treatment with intravenous nicorandil could significantly improve the symptom of dyspnea at 24 h after treatment, as evidenced by the five-point Likert scale for dyspnea after treatment (mean difference [MD]: -0.26, 95% confidence interval [CI]: -0.40 to -0.13, p < 0.001). Furthermore, nicorandil significantly reduced serum B natriuretic peptide (MD: -30.03 ng/dl, 95% CI: -47.00 to -13.06, p < 0.001), and N-terminal proBNP (MD: -138.69, 95% CI: -248.06 to -29.31, p = 0.01). In addition, nicorandil significantly improved ultrasonic parameters including left ventricular ejection fraction and E/e' at discharge. Moreover, during the follow-up duration of up to 90 days, intravenous nicorandil significantly reduced the incidence of major adverse cardiovascular events (risk ratio [RR]: 0.55, 95% CI: 0.32 to 0.93, p = 0.03). The incidence of treatment-related adverse events was not significantly different between nicorandil and controls (RR: 1.22, 95% CI: 0.69 to 2.15, p = 0.49).
Conclusions: Results of this study suggest that intravenous nicorandil may be an effective and safe treatment for patients with ADHF.
期刊介绍:
The principal aim of Scandinavian Cardiovascular Journal is to promote cardiovascular research that crosses the borders between disciplines. The journal is a forum for the entire field of cardiovascular research, basic and clinical including:
• Cardiology - Interventional and non-invasive
• Cardiovascular epidemiology
• Cardiovascular anaesthesia and intensive care
• Cardiovascular surgery
• Cardiovascular radiology
• Clinical physiology
• Transplantation of thoracic organs