Meta AnalysisID 4768
比较美托拉宗与血管加压素拮抗剂作为心力衰竭急性加重辅助利尿疗法的结局：系统评价与Meta分析
CRD42022344305
In patients with heart failure who are present with an acute heart failure exacerbation, does the addition of tolvaptan vs. addition of metolazone to standard diuretic regimen improve patient important outcomes?
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Record Fields
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- Meta Analysis Id
- 4768
- Evidence Id
- 13326
- Core Evidence Id
- 13326
- Source Meta Analysis Id
- 4734
- Herb2 Meta Analysis Id
- HBMA004734
- Crd Id
- CRD42022344305
- Title
- Metolazone vs. Vasopressin Antagonists as Adjuvant Diuretic Therapy in Heart Failure Exacerbation: A Systematic Review and Meta-Analysis of Outcomes
- Review Question
- In patients with heart failure who are present with an acute heart failure exacerbation, does the addition of tolvaptan vs. addition of metolazone to standard diuretic regimen improve patient important outcomes?
- Study Type Included
- RCTs, Observational studies (i.e. case-control, prospective/retrospective cohort), Cross-sectional
- Condition Being Studied
- Acute heart failure exacerbation defined as a sudden or semi-gradual worsening of symptoms, such as vascular or pulmonary congestion, caused by heart failure, often requiring hospitalization.
- Participant
- Inclusion: 1. Adults (18+ years of age) with previously- or newly- diagnosed (using any recognized criteria) congestive heart failure who present with acute exacerbation of heart failure. 2. Adults (18+ years of age) with previously- or newly- diagnosed (using any recognized criteria) congestive heart failure who require hospitalization for heart failure management Exclusion criteria: 1. Adults (18+ years of age) with chronic heart failure who do NOT have signs/symptoms of acute exacerbation 2. Individuals younger than 18 years of age 3. Individuals with signs of vascular or pulmonary congestion NOT caused by exacerbation of heart failure
- Animal
- Human Disease Modelled
- Intervention
- Interventions: 1. Addition of vasopressin antagonist agent (i.e. tolvaptan, conivaptan, lexivaptan, satavaptan) to standard-of-care diuretic therapy (i.e. use of loop diuretics)
- Comparator Control
- Comparison Interventions: 1. Addition of metolazone to standard-of-care diuretic therapy (i.e. use of loop diuretics) 2. Standard-of-care diuretic mono-therapy (i.e. use of loop diuretics alone)
- Main Outcome
- Mortality (30-day, 1-year), Adverse cardiac events, Length-of-hospital-stay (in days), Achievement of decongestion (physician- or patient- assessed) Measures of effect Standard mean difference, % change, RR
- Outcome Measure
- Additional Outcome
- need for rehospitalization, renal impairment (defined as rise in serum Cr > 0.3 mg/dL), improvement in dyspnea (physician- or patient- assessed), change in body weight, urine output (mL/day), change in serum sodium (mEq/L/day), hypokalemia (K < 3.5 mEq/L) amount of loop diuretic used (furosemide-equivalents/day) Measures of effect Standard mean difference, % change, RR
- Study Method
- Individual patient data (IPD) meta-analysis, Meta-analysis, Systematic review
- Keyword
- Antidiuretic Hormone Receptor Antagonists; Diuretics; Heart Failure; Humans; Metolazone; Patient Reported Outcome Measures; Tolvaptan
- Contact
- Matthew Kaye [email protected]
- Organisational Affiliation
- University at Buffalo SUNY
- Funding Source
- This study is unfunded
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- Review Type
- Language
- English
- Country
- United States of America
- Review Stage
- Review Ongoing
- First Submission Date
- 2022-10-12
- Registration Date
- 2022-10-24
- Anticipated Start Date
- 2022-03-01
- Anticipated Completion Date
- 2023-01-01
- Title Cn
- 比较美托拉宗与血管加压素拮抗剂作为心力衰竭急性加重辅助利尿疗法的结局：系统评价与Meta分析
- Title En
- Metolazone vs. Vasopressin Antagonists as Adjuvant Diuretic Therapy in Heart Failure Exacerbation: A Systematic Review and Meta-Analysis of Outcomes
- Bilingual Status
- complete