Champion Sébastien, Lapidus Nathanaël, Cherié Godefroy, Spagnoli Vincent, Oliary Juliette, Solal Alain Cohen
Réanimation Médicale et Toxicologique, Hôpital Lariboisière, Paris, France.
Cardiovasc Ther. 2014 Aug;32(4):159-62. doi: 10.1111/1755-5922.12076.
Pentoxifylline possess antiinflammatory and rheological properties and has been tested in heart failure (HF).
A comprehensive search was performed from 1980 until July 2013 in PubMed, to identify randomized controlled trials evaluating pentoxifylline versus placebo in HF, to determine impact on mortality. Search strategy is as follows: "Pentoxifylline" AND "heart" AND "trial". Study selection of six randomized controlled trials evaluating mortality as outcome. Then, we conducted a meta-analysis of randomized controlled trials versus placebo in HF. Determination of Mantel-Haenszel fixed effect and random-effect pooled odds ratios for all-cause mortality and corresponding 95% confidence intervals.
Data from a total of 221 patients with LVEF ≤40% from six randomized controlled trials were included in this analysis. Pentoxifylline 1200 mg per day was administered during 6 months, except in one study (administered during 1 month for severe acute HF). The use of pentoxifylline was not significantly associated with a reduction in mortality in HF in individual studies. The pooled data including 221 patients showed a nearly fourfold reduction in mortality (5.4% vs. 18.3%; OR 0.29; CI 0.12-0.74; P < 0.01) with homogenous results (I² 0%).
A meta-analysis evaluating pentoxifylline versus placebo in HF suggested a significant nearly fourfold decrease in all-cause mortality in the pentoxifylline group.
己酮可可碱具有抗炎和改善血液流变学特性，已在心力衰竭（HF）中进行了试验。
从1980年至2013年7月在PubMed上进行全面检索，以识别评估己酮可可碱与安慰剂治疗HF的随机对照试验，以确定对死亡率的影响。检索策略如下：“己酮可可碱” AND “心脏” AND “试验”。选择六项以死亡率为结局的随机对照试验进行研究。然后，我们对HF中随机对照试验与安慰剂进行了荟萃分析。确定Mantel-Haenszel固定效应和随机效应合并比值比，用于全因死亡率及相应的95%置信区间。
本分析纳入了来自六项随机对照试验的总共221例左心室射血分数（LVEF）≤40%的患者的数据。除一项研究（严重急性HF患者给药1个月）外，每天给予己酮可可碱1200毫克，持续6个月。在个体研究中，使用己酮可可碱与HF死亡率降低无显著相关性。纳入221例患者的汇总数据显示死亡率降低近四倍（5.4%对18.3%；比值比0.29；置信区间0.12 - 0.74；P < 0.01），结果具有同质性（I² 0%）。
一项评估己酮可可碱与安慰剂治疗HF的荟萃分析表明，己酮可可碱组全因死亡率显著降低近四倍。
