Luo Y, Chen Q
Department of Cardiology Medical, Jiangjin Central Hospital of Chongqing, No. 725 Jiangzhou Road Jiangjin District, 402260, Chongqing, China.
Herz. 2019 Aug;44(5):398-404. doi: 10.1007/s00059-018-4679-1. Epub 2018 Feb 22.
Aliskiren might be beneficial for heart failure. However, the results of various studies are controversial. We conducted a systematic review and meta-analysis to explore the efficacy of aliskiren supplementation for heart failure.
PubMed, Embase, Web of Science, EBSCO, and the Cochrane Library databases were systematically searched. Randomized controlled trials (RCTs) assessing the efficacy of aliskiren for heart failure were included. Two investigators independently searched for articles, extracted data, and assessed the quality of included studies. The meta-analysis was performed using the random-effect model.
Five RCTs comprising 1973 patients were included in the meta-analysis. Compared with control interventions in heart failure, aliskiren supplementation was found to significantly reduce NT-proBNP levels (standardized mean difference [SMD] = -0.12; 95% CI = -0.21 to -0.03 pg/ml; p = 0.008) and plasma renin activity (SMD = -0.66; 95% CI = -0.89 to -0.44 ng/ml.h; p < 0.00001) while increasing plasma renin concentration (SMD = 0.52; 95% CI = 0.30-0.75 ng/l; p < 0.00001); however, it demonstrated no significant influence on BNP levels (SMD = -0.08; 95% CI = -0.31-0.15 pg/ml; p = 0.49), mortality (RR = 0.97; 95% CI = 0.79-1.20; p = 0.79), aldosterone levels (SMD = -0.09; 95% CI = -0.32-0.14 pmol/l; p = 0.44), adverse events (RR = 3.03; 95% CI = 0.18-49.51; p = 0.44), and serious adverse events (RR = 1.34; 95% CI = 0.54-3.33; p = 0.53).
Aliskiren supplementation was found to significantly decrease NT-proBNP levels and plasma renin activity and to improve plasma renin concentration in the setting of heart failure.
阿利吉仑可能对心力衰竭有益。然而，各项研究结果存在争议。我们进行了一项系统评价和荟萃分析，以探讨补充阿利吉仑治疗心力衰竭的疗效。
系统检索了PubMed、Embase、Web of Science、EBSCO和Cochrane图书馆数据库。纳入评估阿利吉仑治疗心力衰竭疗效的随机对照试验（RCT）。两名研究者独立检索文章、提取数据并评估纳入研究的质量。采用随机效应模型进行荟萃分析。
荟萃分析纳入了5项RCT，共1973例患者。与心力衰竭的对照干预措施相比，发现补充阿利吉仑可显著降低N末端脑钠肽前体（NT-proBNP）水平（标准化均数差[SMD]=-0.12；95%可信区间[CI]=-0.21至-0.03 pg/ml；p=0.008）和血浆肾素活性（SMD=-0.66；95%CI=-0.89至-0.44 ng/ml·h；p<0.00001），同时提高血浆肾素浓度（SMD=0.52；95%CI=0.30-0.75 ng/l；p<0.00001）；然而，它对脑钠肽（BNP）水平（SMD=-0.08；95%CI=-0.31-0.15 pg/ml；p=0.49）、死亡率（风险比[RR]=0.97；95%CI=0.79-1.20；p=0.79）、醛固酮水平（SMD=-0.09；95%CI=-0.32-0.14 pmol/l；p=0.44）、不良事件（RR=3.03；95%CI=0.18-49.51；p=0.44）和严重不良事件（RR=1.34；95%CI=0.54-3.33；p=0.53）均无显著影响。
在心力衰竭患者中，发现补充阿利吉仑可显著降低NT-proBNP水平和血浆肾素活性，并改善血浆肾素浓度。
