Heart failure, chronic, diastolic, (preserved ejection fraction): effect of different Drugs tested
DISEASE INTERVENTION COMPARISON RESULTS
N Engl J Med. 2014 Apr 10;370(15):1383-92 Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic, diastolic (preserved ejection fraction) The Use of
aldosterone blockers, spironolactone
As Treatment, Chronic
Is equal Than
placebo
To modify clinical events (cardiovascular death or hospitalization for heart failure) at 3 years: 18.6% spironol. VS 20.4% placebo). Only hospitalizations for HF were reduced (12% spironol. VS 14.2% placebo) but not hospitalizations by any reason
Lancet. 2003 Sep 6;362(9386):777-81 Randomized Controlled Trial
IN heart failure, chronic, diastolic (preserved ejection fraction) The Use of
angiotensin II receptor blockers (candesartan)
As Treatment, Chronic
Is better Than
placebo
To reduce at 3 years admissions to hospital for heart failure (15,2% candesartan VS 18,4% placebo). Cardiovascular death did not differ. Primary composite outcome of both did neither differ
PLoS One. 2014;9(3):e90555 Meta-Analysis
IN heart failure, chronic, diastolic (preserved ejection fraction) The Use of
beta-blockers
As Treatment, Chronic
Is better Than
placebo or no treatment
To reduce all-cause mortality (RR 0.91). But no sig reduction of hospitalizations
J Card Fail. 2010 Mar;16(3):260-7 Meta-Analysis
IN heart failure, chronic, diastolic (preserved ejection fraction) The Use of
renin-angiotensin system inhibitors, angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB)
As Treatment, Chronic
Is equal Than
placebo
To reduce hospitalizations for heart failure or all-cause mortality.
Heart. 2018 Mar;104(5):407-415 Meta-Analysis
IN heart failure, chronic, diastolic (preserved ejection fraction) The Use of
various medical treatments: angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), beta blockers, aldosterone blockers, spironolactone
As Treatment, Chronic
Is equal Than
placebo
To modify survival (except beta blockers, associated with reduced all-cause and cardiac deaths, (RR: 0.78) or reduce rehospitalizations or improve functional capacity
J Am Coll Cardiol. 2011 Apr 19;57(16):1676-86 Meta-Analysis
IN heart failure, chronic, diastolic (preserved ejection fraction) The Use of
various medical treatments: angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), beta blockers, others
As Treatment, Chronic
Is better Than
placebo ou usual care without those treatments
To improve excercise tolerance (51 to 61 more seconds on treadmill excercise test) but not heart fonction (E/A ratio) nor mortality
Eur Heart J. 2006 Oct;27(19):2338-45 Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic, diastolic (preserved ejection fraction), elder patients The Use of
angiotensin converting enzyme inhibitors (ACEI), perindopril
As Treatment, Chronic
Is better Than
placebo
To reduce at 1 year hospitalizations for heart failure (HR 0.63) and improve functional class. However, differences in primary combined outcome at 2 years were not significant
J Am Coll Cardiol. 2009 Jun 9;53(23):2150-8 Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic, diastolic (preserved ejection fraction), elder patients The Use of
beta blockers, nebivolol (Temerit TM)
As Treatment, Chronic
Is better Than
placebo
To reduce, at 21 months, a composite of all-cause mortality or cardiovascular hospitalizations equally in patients with preserved EF and in those with reduced EF.
Circulation. 2006 Aug 1;114(5):397-403. Epub 2006 Jul 24 Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic, diastolic (preserved ejection fraction), in sinus rhythm The Use of
digoxin
As Treatment, Chronic
Is equal Than
placebo
To modify death or hospitalization caused by heart failure: 21% with digoxin VS 24% placebo
Eur Heart J. 2005 Feb;26(3):215-25 Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic, diastolic (preserved ejection fraction), systolic, elder patients The Use of
beta blockers, nebivolol (Temerit TM)
As Treatment, Chronic
Is better Than
placebo
To reduce, at 21 months, a composite of death from all causes and cardiovascular hospital admission: 31% nebivolol VS 35% placebo. There were a non-significant reduction of death: 16% nebivolol VS 18% placebo.