Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Postponement of Death by Pharmacological Heart Failure Treatment: A Meta-Analysis of Randomized Clinical Trials

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Does Subclinical Hypothyroidism Add Any Symptoms? evidence from a Danish population-based study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Antimycotic treatment of oral candidiasis in warfarin users

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Thiazolidinediones and Risk of Atrial Fibrillation Among Patients with Diabetes and Coronary Disease

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Three of a (Peptic) Kind!

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Serum Potassium and Mortality in High-Risk Patients: SPRINT

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Mortality and ventricular arrhythmia after acute myocarditis: a nationwide registry-based follow-up study

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Predictive Importance of Blood Pressure Characteristics With Increasing Age in Healthy Men and Women: The MORGAM Project

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Morten Rix Hansen
  • Asbjørn Hróbjartsson
  • Lars Videbæk
  • Zandra Nymand Ennis
  • Manan Pareek
  • Niels Herluf Paulsen
  • Martin Broe
  • Morten Olesen
  • Anton Pottegård
  • Per Damkier
  • Jesper Hallas
View graph of relations

Background: Outcome postponement has been proposed as an effect measure for preventive drug treatment. It describes the average delay of the investigated unwanted clinical event, achieved by taking medication. The objective was to estimate postponement of death for the following heart failure medications compared to placebo: beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), ARB added to ACE inhibitors, aldosterone antagonists, ivabradine, and renin antagonists. Methods: We searched Medline and Embase from inception of databases until October 2017. Eligibility criteria were randomized placebo-controlled heart failure trials, including at least 1000 participants, with survival as a prespecified outcome and a minimum trial duration of 1 year. We calculated the outcome postponement by modeling the area between survival curves. This area was modeled on the basis of the hazard ratio or relative risk, the rate of mortality in the placebo group, and the trial duration. All results were standardized to a 3-year trial duration to ensure comparability between treatments. Results: We identified 14 eligible trials, with a total of 52,014 patients. The results in terms of postponement of all-cause mortality was: beta-blockers 43.7 days (95% confidence interval [95% CI], 20.8-66.5), ACE inhibitors 41.0 days (95% CI, 18.8-63.3), and aldosterone-antagonists 41.3 days (95% CI, 14.3,68.4). Conclusion: The modeled outcome postponement estimates reiterate beta-blockers, ACE inhibitors, and aldosterone antagonists as the mainstay of heart failure treatment. Furthermore, ivabradine or ARBs added to ACE inhibitors results in no statistically significant gain in survival.

Original languageEnglish
JournalAmerican Journal of Medicine
Volume133
Issue number6
Pages (from-to)e280-e289
ISSN0002-9343
DOIs
Publication statusPublished - Jun 2020

    Research areas

  • Effect measure, Heart failure, Meta-analysis, Outcome postponement, Randomized Controlled Trial, Angiotensin-Converting Enzyme Inhibitors/therapeutic use, Cardiovascular Agents/therapeutic use, Humans, Mineralocorticoid Receptor Antagonists/therapeutic use, Survival Rate, Adrenergic beta-Antagonists/therapeutic use, Cause of Death, Ivabradine/therapeutic use, Randomized Controlled Trials as Topic, Heart Failure/drug therapy, Angiotensin Receptor Antagonists/therapeutic use, Drug Therapy, Combination

ID: 59580085