Letter by Fung et al Regarding Article, “Frailty and Clinical Outcomes in Heart Failure: A Systematic Review and Meta-analysis”

2018 ◽  
Vol 19 (12) ◽  
pp. 1143-1146
Author(s):  
Erik Fung ◽  
Xiaobo Yang ◽  
Phillip J. Newton ◽  
Caleb Ferguson ◽  
Paloma Gastelurrutia ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Clinical Outcomes ◽  
Meta Analysis

Glycated hemoglobin as a surrogate for evaluating the effectiveness of drugs in diabetes mellitus trials: a systematic review and trial-level meta-analysis

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Paola Andrea Rivera ◽  
Milton J. M. Rodríguez-Zúñiga ◽  
José Caballero-Alvarado ◽  
Fabián Fiestas
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Systematic Review ◽  
Clinical Outcomes ◽  
Randomized Clinical Trials ◽  
Glycated Hemoglobin ◽  
Meta Analysis ◽  
Strong Association ◽  
Kidney Injury

Abstract Objective The objective of this study was to investigate whether glycated hemoglobin (HbA1c) is a valid surrogate for evaluating the effectiveness of antihyperglycemic drugs in diabetes mellitus (DM) trials. Methods We conducted a systematic review of placebo-controlled randomized clinical trials (RCTs) evaluating the effect of a treatment on HbA1c (mean difference between groups) and clinical outcomes (relative risk of mortality, myocardial infarction, stroke, heart failure, and/or kidney injury) in patients with DM. Then, we investigated the association between treatment effects on HbA1c and clinical outcomes using regression analysis at the trial level. Lastly, we interpreted the correlation coefficients (R) using the cut-off points suggested by the Institute for Quality and Efficiency in Healthcare (IQWiG). HbA1c was considered a valid surrogate if it demonstrated a strong association: lower limit of the 95 percent confidence interval (95 percent CI) of R greater than or equal to .85. Results Nineteen RCTs were identified. All studies included adults with type 2 DM. None of the associations evaluated was strong enough to validate HbA1c as a surrogate for any clinical outcome: mortality (R = .34; 95 percent CI −.14 to .69), myocardial infarction (R = .20; −.30 to .61), heart failure (R = .08; −.40 to .53), kidney injury (R = −.04; −.52 to .47), and stroke (R = .81; .54 to .93). Conclusions The evidence from multiple placebo-controlled RCTs does not support the use of HbA1c as a surrogate to measure the effectiveness of antihyperglycemic drugs in DM studies.

Abstract 118: Right Bundle Branch Block and Clinical Outcomes in Patients with Heart Failure: A Systematic Review and Meta-analysis

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Ahmad Hazem ◽  
Sunita Sharma ◽  
Amit Sharma ◽  
Cameron Leitch ◽  
Roopalakshmi Sharadanant ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Clinical Outcomes ◽  
Cardiovascular Mortality ◽  
Observational Studies ◽  
Meta Analysis ◽  
Bundle Branch Block ◽  
Increased Risk ◽  
Patients With Heart Failure ◽  
All Cause Mortality

Importance: Right bundle branch block (RBBB) is observed in approximately 5-14% of patients with heart failure (HF). Multiple observational studies have reported the association of RBBB with clinical outcomes in patients with HF. We performed a systematic review and meta-analysis to determine the prognostic significance of RBBB for patients with HF. Data Sources: We have systematically searched MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science and Scopus through January 2014. Study Selection: Reviewers working independently and in duplicate screened all eligible abstracts that described all cause or cardiovascular mortality in patients with RBBB and HF. We excluded studies that reported unadjusted outcome, i.e.: unadjusted event rates. Knowledge synthesis: We pooled reported risk ratio and hazard ratio. Main Outcomes: All-cause mortality and cardiovascular mortality (death). Results: We found 12 relevant observational studies enrolling over 38,000 patients. Risk of bias was assessed using the Newcastle-Ottawa Scale. Included studies had at least a moderate quality. Seven of those evaluated prognosis of patients with RBBB and heart failure. After a mean follow up period of 2.5 years (range: 1-5 years), RBBB was associated with a statistically significant increased risk of all-cause mortality compared to patients with heart failure but no BBB, RR 1.27, 95% CI (1.08-1.50), Figure 1. The other 5 studies evaluated CHF patients receiving cardiac resynchronization therapy (CRT), comparing outcomes of patients with RBBB to those with LBBB. After a mean f/u period of 3 years, patients with RBBB were once again found to have an increased risk of all-cause mortality, RR 1.45, 95% CI 1.12-1.89. Conclusion and Relevance: RBBB in patients with HF is associated with higher all-cause mortality in comparison to patients without inter-ventricular conduction defects, as well as LBBB patients in patients undergoing CRT setting.

scholarly journals Correction to: Association of statin use and clinical outcomes in heart failure patients: a systematic review and meta-analysis

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Agata Bielecka-Dabrowa ◽  
Ibadete Bytyçi ◽  
Stephan Von Haehling ◽  
Stefan Anker ◽  
Jacek Jozwiak ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Heart Failure Patients ◽  
Statin Use

An amendment to this paper has been published and can be accessed via the original article.

Frailty and Clinical Outcomes in Heart Failure: A Systematic Review and Meta-analysis

2018 ◽  
Vol 19 (11) ◽  
pp. 1003-1008.e1 ◽  
Author(s):  
Yunpeng Zhang ◽  
Ming Yuan ◽  
Mengqi Gong ◽  
Gary Tse ◽  
Guangping Li ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Clinical Outcomes ◽  
Meta Analysis
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