Effects of mineralocorticoid receptor antagonists on the risk of thrombosis, bleeding and mortality: A systematic review and meta-analysis of randomized controlled trials

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61989592%3A15110%2F16%3A33161918" target="_blank" >RIV/61989592:15110/16:33161918 - isvavai.cz</a>

Result on the web

<a href="http://www.sciencedirect.com/science/article/pii/S0049384816303310" target="_blank" >http://www.sciencedirect.com/science/article/pii/S0049384816303310</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.thromres.2016.04.027" target="_blank" >10.1016/j.thromres.2016.04.027</a>

Result language

angličtina

Original language name

Effects of mineralocorticoid receptor antagonists on the risk of thrombosis, bleeding and mortality: A systematic review and meta-analysis of randomized controlled trials

Original language description

Introduction: Aldosterone seems to influence the haemostatic systemby several mechanisms and to increase the risk of thrombosis. The objective of this meta-analysis was to assess the impact of inhibition of the mineralocorticoid receptor due to the use of mineralocorticoid receptor antagonists (MRAs) on venous and arterial thrombosis, bleeding events and mortality. Materials and methods: We systematically searched PubMed and EMBASE through August 1, 2014, without language restrictions. Randomised controlled trials (RCTs) that tested the effect of MRAs versus active control/no treatment and reported data on thrombotic or bleeding events or mortality in patients with common causes of secondary hyperaldosteronism were included. Results: 20 published RCTs reported in 19 papers for a total of 17,610 patients met inclusion criteria. Of these, all reported data on mortality, 15 on cardiovascular mortality, 14 on thrombotic events and 12 reported data on bleeding events. No RCTs investigated patients with primary hyperaldosteronism. 19 RCTswere performed in patients with hypertension and heart failure. In general, the heterogeneity was low. No differences were observed in arterial thrombotic and bleeding events. Patients treatedwithMRAs had 20% lower odds of total mortality and 23% of cardiovascularmortality compared with controls (odds ratio (OR) 0.80, 95% confidence interval (CI) 0.73- 0.87 and OR 0.77, 95% CI 0.70-0.85, respectively). Conclusion: Inhibition of the mineralocorticoid receptor with MRAs in patients with hypertension and heart failure does not change the risk ofmyocardial infarction, stroke and bleeding events. Ourmeta-analysis confirms the favourable effects ofMRAs on total and cardiovascular mortality. These data suggest thatMRAs can be considered as safe regarding their effects on haemostasis in patients with hypertension and heart failure.

Czech name

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Czech description

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Type

J_x - Unclassified - Peer-reviewed scientific article (Jimp, Jsc and Jost)

CEP classification

FA - Cardiovascular diseases including cardio-surgery

OECD FORD branch

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Project

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Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2016

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Thrombosis Research

ISSN

0049-3848

e-ISSN

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Volume of the periodical

144

Issue of the periodical within the volume

1

Country of publishing house

GB - UNITED KINGDOM

Number of pages

8

Pages from-to

32-39

UT code for WoS article

000381913800006

EID of the result in the Scopus database

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