Department of Nursing, Shanghai JiaoTong University Affiliated Sixth People's Hospital, 600 Yishan Road, Xuhui District, Shanghai 200233, China; School of Nursing, Shanghai JiaoTong University School of Medicine, No. 227 South Chongqing Road, 200025 Shanghai, China.
School of Nursing, Shanghai JiaoTong University School of Medicine, No. 227 South Chongqing Road, 200025 Shanghai, China.
Complement Ther Med. 2022 Nov;70:102853. doi: 10.1016/j.ctim.2022.102853. Epub 2022 Jul 13.
Micronutrients can benefit patients with heart failure (HF). Thiamine is a critical vitamin, while the impact of thiamine supplementation on patients with HF remains unclear. Systematic review and meta-analysis were conducted to evaluate the effects of thiamine supplementation on clinical outcomes in patients with HF.
Databases including Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Scopus, and CNKI were searched from inception to June 29th 2022. Randomized controlled trials (RCTs) comparing thiamine supplementation with placebo were included. Meta-analysis was conducted with the software Review Manager 5.4. The quality assessment was performed according to Cochrane Risk of Bias Tool 2.0.
Eight studies including 384 patients were included in this review. The results of overall systematic review showed no benefit of thiamine supplementation in HF patients. Compared with the control group, the experimental group had no statistically significant improvements in LVEF (Mean Difference, - 0.19; 95 % CI, - 2.78 to 0.96; I = 49 %; P = 0.10) in patients with chronic heart failure (CHF). Other outcomes including NYHA class, BNP or NT-proBNP, thiamine status, symptom changes, and quality of life were not improved by thiamine supplementation in CHF patients. Similarly, no improvements in clinical outcomes were found in patients with acute heart failure (AHF) in the studies included.
This systematic review and meta-analysis found no evidence to support the effects of thiamine supplementation in patients with HF, though thiamine supplementation is promising in improving cardiac functions, thiamine status and relieving HF-related symptoms. More well-designed RCTs with large sample sizes are required.
微量营养素可使心力衰竭（HF）患者受益。硫胺素是一种重要的维生素，而硫胺素补充对 HF 患者的影响尚不清楚。系统评价和荟萃分析评估了硫胺素补充对 HF 患者临床结局的影响。
从建库至 2022 年 6 月 29 日，检索 Cochrane 中央对照试验注册库（CENTRAL）、PubMed、Embase、Scopus 和中国知网（CNKI）数据库。纳入比较硫胺素补充与安慰剂的随机对照试验（RCT）。使用 Review Manager 5.4 软件进行荟萃分析。根据 Cochrane 偏倚风险工具 2.0 进行质量评估。
纳入 8 项研究共 384 例患者。整体系统评价结果显示，HF 患者硫胺素补充无益。与对照组相比，实验组慢性心力衰竭（CHF）患者的 LVEF（均数差，-0.19；95%CI，-2.78 至 0.96；I²=49%；P=0.10）无统计学意义的改善。其他结局，包括 NYHA 分级、BNP 或 NT-proBNP、硫胺素状态、症状变化和生活质量，CHF 患者也未因硫胺素补充而改善。同样，纳入研究中急性心力衰竭（AHF）患者的临床结局也未改善。
本系统评价和荟萃分析未发现证据支持硫胺素补充对 HF 患者有效，尽管硫胺素补充在改善心脏功能、硫胺素状态和缓解 HF 相关症状方面有一定前景，但仍需要更多设计良好、样本量大的 RCT 来验证。
