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

Kód výsledku v 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>

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

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

Popis výsledku anglicky

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.

Druh

J_x - Nezařazeno - Článek v odborném periodiku (Jimp, Jsc a Jost)

CEP obor

FA - Kardiovaskulární nemoci včetně kardiochirurgie

OECD FORD obor

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Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2016

Kód důvěrnosti údajů

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

Název periodika

Thrombosis Research

ISSN

0049-3848

e-ISSN

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Svazek periodika

144

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

8

Strana od-do

32-39

Kód UT WoS článku

000381913800006

EID výsledku v databázi Scopus

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