维立西呱治疗心力衰竭：一项系统评价与荟萃分析。
Vericiguat treatment of heart failure: A systematic review and meta-analysis.
作者信息
Yang Heng, Luo Chao, Lan Wan-Qi, Tang Yan-Hua
机构信息
Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330008, Jiangxi Province, China.
出版信息
World J Clin Cases. 2023 Dec 16;11(35):8330-8342. doi: 10.12998/wjcc.v11.i35.8330.
BACKGROUND
Heart failure (HF), an end-stage manifestation of various cardiac diseases, poses an enormous economic and health burden on society. Vericiguat may be an effective drug in the treatment of HF.
AIM
To explore by meta-analysis the efficacy and safety of Vericiguat in treating chronic heart failure.
METHODS
Databases, including PubMed, EMBASE, Web of Science, and Cochrane Library, were searched to collect all published randomized controlled trials (RCTs) on Vericiguat treatment of chronic heart failure from the earliest electronic records to those published in March 2023. Two investigators independently screened the literature according to inclusion and exclusion criteria, evaluated the quality of the studies, and extracted valid data before conducting a meta-analysis using RevMan5.4.
RESULTS
Four RCTs with 5919 patients were included, and the meta-analysis showed that treatment with 10 mg Vericiguat reduced the incidence of the primary endpoint (a composite of cardiovascular mortality and first heart-failure-related hospitalization) in patients with chronic heart failure compared to placebo [relative risk (RR) = 0.91, 95% confidence interval (CI): 0.85-0.98, = 0.01], and reduced the incidence of heart-failure-related hospitalization (RR = 0.92, 95%CI: 0.84-1.00, = 0.05). However, for the incidence of cardiovascular and all-cause death, there were no significant differences between the Vericiguat and placebo groups. In addition, the two groups did not show significant differences in blood pressure, heart rate, and Kansas Cardiomyopathy Questionnaire physical limitation score. In terms of safety, 10 mg Vericiguat did not increase the risk of adverse effects in patients with chronic heart failure. Vericiguat may increase the risk of symptomatic hypotension (RR = 1.17, 95%CI: 0.98-1.39, = 0.08) and syncope (RR = 1.18, 95%CI: 0.90-1.55, = 0.24), but not significantly.
CONCLUSION
Vericiguat (10 mg) was more effective than placebo in treating patients with chronic heart failure and had a better safety profile.
背景
心力衰竭（HF）是各种心脏疾病的终末期表现，给社会带来了巨大的经济和健康负担。维立西呱可能是治疗HF的一种有效药物。
目的
通过荟萃分析探讨维立西呱治疗慢性心力衰竭的疗效和安全性。
方法
检索包括PubMed、EMBASE、Web of Science和Cochrane图书馆在内的数据库，收集从最早的电子记录到2023年3月发表的所有关于维立西呱治疗慢性心力衰竭的已发表随机对照试验（RCT）。两名研究者根据纳入和排除标准独立筛选文献，评估研究质量，并提取有效数据，然后使用RevMan5.4进行荟萃分析。
结果
纳入了4项RCT，共5919例患者，荟萃分析显示，与安慰剂相比，10mg维立西呱治疗可降低慢性心力衰竭患者主要终点（心血管死亡和首次心力衰竭相关住院的复合终点）的发生率[相对危险度（RR）=0.91，95%置信区间（CI）：0.85-0.98，P=0.01]，并降低心力衰竭相关住院的发生率（RR=0.92，95%CI：0.84-1.00，P=0.05）。然而，在心血管死亡和全因死亡的发生率方面，维立西呱组和安慰剂组之间没有显著差异。此外，两组在血压、心率和堪萨斯心肌病问卷身体限制评分方面也没有显著差异。在安全性方面，10mg维立西呱不会增加慢性心力衰竭患者不良反应的风险。维立西呱可能会增加症状性低血压（RR=1.17，95%CI：0.98-1.39，P=0.08）和晕厥（RR=1.18，95%CI：0.90-1.55，P=0.24）的风险，但差异不显著。
结论
维立西呱（10mg）治疗慢性心力衰竭患者比安慰剂更有效，且安全性更好。
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