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阿利吉仑对高血压前期患者心血管结局的影响:一项随机对照试验的荟萃分析。

Effect of aliskiren on cardiovascular outcomes in patients with prehypertension: a meta-analysis of randomized controlled trials.

作者信息

Zhang Jing-Tao, Chen Ke-Ping, Guan Ting, Zhang Shu

机构信息

Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.

出版信息

Drug Des Devel Ther. 2015 Apr 2;9:1963-71. doi: 10.2147/DDDT.S75111. eCollection 2015.

Abstract

BACKGROUND

Aliskiren is a widely used therapy for patients with hypertension, however, the effect of aliskiren on major cardiovascular outcomes is a matter of debate. The aim of this study is to evaluate the effects of aliskiren therapy on major cardiovascular outcomes by this meta-analysis of randomized controlled trials.

METHODS

We searched PubMed, EmBase, and the Cochrane Central Register of Controlled Trials for relevant literature. All eligible studies were randomized controlled trials assessing the effect of aliskiren therapy compared with patients without aliskiren therapy. Relative risks (RRs) with 95% confidence intervals (CIs) were used to measure the effect of aliskiren therapy on major cardiovascular outcomes with a random-effect model.

RESULTS

We included six trials reporting data on 12,465 patients. These studies reported 1,886 occurrences of major cardiovascular events, 1,074 events of total mortality, 739 events of cardiac death, 366 events of myocardial infarction, and 319 events of stroke. Aliskiren therapy had no effect on major cardiovascular events (RR, 0.93; 95% CI: 0.77-1.13; P=0.47), total mortality (RR, 1.00; 95% CI: 0.77-1.29; P=1.00), cardiac death (RR, 1.01; 95% CI: 0.79-1.29; P=0.95), myocardial infarction (RR, 0.71; 95% CI: 0.36-1.38; P=0.31), or stroke (RR, 0.87; 95% CI: 0.48-1.58; P=0.64).

CONCLUSION

Aliskiren therapy does not have an effect on the incidence of major cardiovascular events, total mortality, cardiac death, myocardial infarction, or stroke.

摘要

背景

阿利吉仑是一种广泛用于高血压患者的治疗药物,然而,阿利吉仑对主要心血管结局的影响存在争议。本研究的目的是通过对随机对照试验的荟萃分析来评估阿利吉仑治疗对主要心血管结局的影响。

方法

我们检索了PubMed、EmBase和Cochrane对照试验中心注册库中的相关文献。所有符合条件的研究均为随机对照试验,评估阿利吉仑治疗与未接受阿利吉仑治疗的患者相比的效果。采用随机效应模型,用95%置信区间(CI)的相对风险(RR)来衡量阿利吉仑治疗对主要心血管结局的影响。

结果

我们纳入了6项试验,报告了12465例患者的数据。这些研究报告了1886例主要心血管事件、1074例全因死亡事件、739例心源性死亡事件、366例心肌梗死事件和319例中风事件。阿利吉仑治疗对主要心血管事件(RR,0.93;95%CI:0.77-1.13;P=0.47)、全因死亡(RR,1.00;95%CI:0.77-1.29;P=1.00)、心源性死亡(RR,1.01;95%CI:0.79-1.29;P=0.95)、心肌梗死(RR,0.71;95%CI:0.36-1.38;P=0.31)或中风(RR,0.87;95%CI:0.48-1.58;P=0.64)均无影响。

结论

阿利吉仑治疗对主要心血管事件、全因死亡、心源性死亡、心肌梗死或中风的发生率没有影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05f0/4396461/2b2e3a2df5e5/dddt-9-1963Fig1.jpg

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