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钙通道阻滞剂对射血分数保留的心力衰竭患者的影响:系统评价和荟萃分析方案。

Effects of calcium channel blockers in patients with heart failure with preserved ejection fraction: A protocol for systematic review and meta-analysis.

机构信息

Core Laboratory, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

出版信息

PLoS One. 2024 Aug 19;19(8):e0307258. doi: 10.1371/journal.pone.0307258. eCollection 2024.

Abstract

BACKGROUND

Nearly half of patients with heart failure (HF) have preserved ejection fraction (EF) and the mortality and morbidity of patients with HF with preserved EF (HFpEF) are high. Patients with HFpEF are often elderly and their primary chronic symptom is severe exercise intolerance. Due to the frequent coexistence of hypertension in HFpEF patients, the use of anti-hypertensive medications is common in their treatment. While many cohort studies and several randomized controlled trials (RCTs) have examined the effectiveness of various anti-hypertensive drugs such as beta-blockers and renin-angiotensin system inhibitors in HFpEF, the role of calcium channel blockers (CCBs) remains uncertain. Despite several RCTs and cohort studies exploring the effects of CCBs on prognosis and exercise capacity in HFpEF patients, the findings have been inconsistent, likely due to limited statistical power and/or variations in study design. Therefore, our aim is to conduct a systematic review and meta-analysis of studies on the effects of CCBs in these patients.

METHODS

This meta-analysis will include RCTs and cohort studies on the effect of CCBs in HFpEF patients. Information of studies will be collected from PubMed, Web of Science, and Scopus. The primary outcome of interest will be prognosis. The secondary outcome of interest will be exercise capacity.

DISCUSSION

Synthesizing our meta-analytical results with expert consensus could contribute to the formulation of updated clinical guidelines. Our systematic review and meta-analysis will provide directions for future research on the use of CCBs in HFpEF patients.

SYSTEMATIC REVIEW REGISTRATION

INPLASY202430097.

摘要

背景

近一半的心衰(HF)患者射血分数保留(EF),HF 伴射血分数保留(HFpEF)患者的死亡率和发病率都很高。HFpEF 患者通常年龄较大,其主要慢性症状是严重的运动不耐受。由于 HFpEF 患者常伴有高血压,因此在治疗中常使用抗高血压药物。虽然许多队列研究和几项随机对照试验(RCT)已经研究了各种抗高血压药物(如β受体阻滞剂和肾素-血管紧张素系统抑制剂)在 HFpEF 中的疗效,但钙通道阻滞剂(CCB)的作用仍不确定。尽管有几项 RCT 和队列研究探讨了 CCB 对 HFpEF 患者预后和运动能力的影响,但结果不一致,可能是由于统计效力有限和/或研究设计的差异。因此,我们的目的是对 CCB 治疗 HFpEF 患者的效果进行系统评价和荟萃分析。

方法

本荟萃分析将包括关于 CCB 对 HFpEF 患者影响的 RCT 和队列研究。将从 PubMed、Web of Science 和 Scopus 收集研究信息。主要观察终点为预后。次要观察终点为运动能力。

讨论

将我们的荟萃分析结果与专家共识相结合,可能有助于制定更新的临床指南。我们的系统评价和荟萃分析将为未来研究 CCB 在 HFpEF 患者中的应用提供方向。

系统评价注册

INPLASY202430097。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faab/11332996/f1718f8402a0/pone.0307258.g001.jpg

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