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https://www.rpr.lib.ok.us/taxonomy/term/4543/all en https://www.rpr.lib.ok.us/resource/meta-analysis-evaluating-effects-renin-angiotensin-aldosterone-system-blockade-outcomes <div class="field field-name-field-artifact-uploaded-date field-type-datetime field-label-inline clearfix"> <div class="field-label">Date Added:&nbsp;</div> <div class="field-items"> <div class="field-item even"><span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2020-03-14T00:00:00-05:00">March 14, 2020</span></div> </div> </div> <div class="field field-name-field-artifact-journal field-type-text field-label-inline clearfix"> <div class="field-label">Journal/Publication:&nbsp;</div> <div class="field-items"> <div class="field-item even">The American Journal of Cardiology</div> </div> </div> <div class="field field-name-field-artifact-publisher field-type-text field-label-inline clearfix"> <div class="field-label">Publisher:&nbsp;</div> <div class="field-items"> <div class="field-item even">Elsevier Inc.</div> </div> </div> <div class="field field-name-field-artifact-published-date field-type-datetime field-label-inline clearfix"> <div class="field-label">Publication Date:&nbsp;</div> <div class="field-items"> <div class="field-item even"><span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2020-01-30T00:00:00-06:00">January 30, 2020</span></div> </div> </div> <div class="field field-name-field-artifact-url field-type-link-field field-label-inline clearfix"> <div class="field-label">URL:&nbsp;</div> <div class="field-items"> <div class="field-item even"><a href="https://www.ncbi.nlm.nih.gov/pubmed/32081366" target="_blank">Meta-Analysis Evaluating the Effects of Renin-Angiotensin-Aldosterone System Blockade on Outcomes of Heart Failure With Preserved Ejection Fraction</a></div> </div> </div> <div class="field field-name-field-artifact-type field-type-taxonomy-term-reference field-label-inline clearfix"> <div class="field-label">Type:&nbsp;</div> <div class="field-items"> <div class="field-item even">Meta-analyses, Reviews, and Guidelines</div> </div> </div> <div class="field field-name-field-artifact-format field-type-taxonomy-term-reference field-label-inline clearfix"> <div class="field-label">Format:&nbsp;</div> <div class="field-items"> <div class="field-item even">Article</div> </div> </div> <div class="field field-name-field-artifact-doi-1 field-type-text field-label-inline clearfix"> <div class="field-label">DOI (1):&nbsp;</div> <div class="field-items"> <div class="field-item even">10.1016/j.amjcard.2020.01.009</div> </div> </div> <div class="field field-name-field-artifact-keywords field-type-taxonomy-term-reference field-label-above"> <div class="field-label">Keywords&nbsp;</div> <div class="field-items"> <div class="field-item even"><a href="/tags/raas-anatgonists" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">RAAS Anatgonists</a></div> <div class="field-item odd"><a href="/tags/heart-failure" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">heart failure</a></div> </div> </div> <div class="field field-name-field-artifact-pmid-1 field-type-text field-label-inline clearfix"> <div class="field-label">PMID (1):&nbsp;</div> <div class="field-items"> <div class="field-item even">32081366</div> </div> </div> <div class="field field-name-field-artifact-mesh field-type-taxonomy-term-reference field-label-above"> <div class="field-label">MeSH&nbsp;</div> <div class="field-items"> <div class="field-item even"><a href="/mesh/humans" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Humans</a></div> <div class="field-item odd"><a href="/mesh/sacubitril-valsartan" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">sacubitril-valsartan</a></div> <div class="field-item even"><a href="/mesh/candesartan" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">candesartan</a></div> <div class="field-item odd"><a href="/mesh/valsartan" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Valsartan</a></div> <div class="field-item even"><a href="/mesh/angiotensin-receptor-antagonists" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Angiotensin Receptor Antagonists</a></div> <div class="field-item odd"><a href="/mesh/spironolactone" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Spironolactone</a></div> <div class="field-item even"><a href="/mesh/irbesartan" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Irbesartan</a></div> <div class="field-item odd"><a href="/mesh/perindopril" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Perindopril</a></div> <div class="field-item even"><a href="/mesh/heart-failure" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">heart failure</a></div> <div class="field-item odd"><a href="/mesh/neprilysin" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Neprilysin</a></div> <div class="field-item even"><a href="/mesh/renin-angiotensin-system" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">renin-angiotensin system</a></div> <div class="field-item odd"><a href="/mesh/stroke-volume" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Stroke Volume</a></div> <div class="field-item even"><a href="/mesh/confidence-intervals" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Confidence Intervals</a></div> <div class="field-item odd"><a href="/mesh/medline" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">MEDLINE</a></div> <div class="field-item even"><a href="/mesh/network-meta-analysis" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Network Meta-Analysis</a></div> <div class="field-item odd"><a href="/mesh/tetrazoles" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Tetrazoles</a></div> <div class="field-item even"><a href="/mesh/aminobutyrates" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Aminobutyrates</a></div> <div class="field-item odd"><a href="/mesh/benzimidazoles" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Benzimidazoles</a></div> <div class="field-item even"><a href="/mesh/hospitalization" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">hospitalization</a></div> <div class="field-item odd"><a href="/mesh/angiotensins" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Angiotensins</a></div> </div> </div> <div class="field field-name-field-artifact-editor-note field-type-text-long field-label-hidden"> <div class="field-items"> <div class="field-item even"><p>ACEIs, ARBs, and spironolactone do not appear to reduce mortality or CHF hospitalizations in patients with CHF with preserved LV function.  However, the combination of sacubitril (a neprilysin inhibitor) and valsartan may reduce CHF hospitalizations in those patients. James W. Mold, MD, MPH</p> </div> </div> </div> <div class="field field-name-field-artifact-text-availability field-type-list-text field-label-hidden"> <div class="field-items"> <div class="field-item even">Commercial full text (fees may apply)</div> </div> </div> <div class="field field-name-field-artifact-document-content field-type-entityreference field-label-hidden"> <div class="field-items"> <div class="field-item even"><div class="view view-artifact-docs view-id-artifact_docs view-display-id-block view-dom-id-8a235ba42149272e5268f8107b86ea34"> <div class="view-content"> <div class="views-row views-row-1 views-row-odd views-row-first views-row-last"> <a href="https://doi.org/10.1016/j.amjcard.2020.01.009" class="btn btn-primary" target="_blank">View</a> </div> </div> </div></div> </div> </div> <div class="field field-name-body field-type-text-with-summary field-label-hidden"> <div class="field-items"> <div class="field-item even" property="content:encoded"><p>Clinical trials of renin-angiotensin-aldosterone system (RAAS) antagonists in heart failure with preserved ejection fraction (HFpEF) have suggested neutral results and treatment is focused on associated symptoms and comorbidities. MEDLINE and EMBASE were searched through October 2019 for randomized controlled studies investigating the effects of different RAAS antagonists in patients with HFpEF. The main outcomes were all-cause mortality, trial defined cardiovascular mortality, and heart failure (HF) hospitalizations. To compare different RAAS antagonists, a random-effects restricted-maximum-likelihood network meta-analysis based on a frequentist framework for indirect and mixed comparisons was used. We used p scores to rank best treatments per outcome. Our search identified 5 eligible clinical trials (PEP-CHF, perindopril; CHARM-preserved, candesartan; I-PRESERVE, irbesartan; TOPCAT, spironolactone; PARAGON-HF, sacubitril-valsartan and valsartan) enrolling a total 10,523 on RAAS antagonists and 6,259 controls. We did not identify any statistical difference in all-cause and cardiovascular mortality among RAAS antagonists and placebo. The combination of sacubitril-valsartan was associated with significantly decreased HF hospitalization risk compared with controls (odds ratio 0.73, 95% confidence interval 0.61 to 0.87) and angiotensin II receptor blockers (odds ratio 0.80, 95% confidence interval 0.71 to 0.91), without heterogeneity among studies (I2 = 0). Angiotensin receptor neprilysin inhibitor (ARNI) ranked better than other RAAS antagonists for HF hospitalizations (p value 0.9). In conclusion, RAAS antagonists do not affect mortality but the combination of sacubitril-valsartan is associated with lower HF hospitalizations in HFpEF patients.</p> </div> </div> </div> <div class="field field-name-field-resource-author field-type-taxonomy-term-reference field-label-inline clearfix"> <div class="field-label">Author/s:&nbsp;</div> <div class="field-items"> <div class="field-item even">Kuno, T, Ueyama, H, Fujisaki, T, Briasouli, A, Takagi, H, Briasoulis, A</div> </div> </div> Sat, 14 Mar 2020 20:03:18 +0000 John Bayhi 1020 at https://www.rpr.lib.ok.us