heart failure

systematic review meta-analysis network meta-analysis

Select surgerycell-based therapies regenerative therapyBNP guided management telemonitoringaldosterone blockade diureticsmineralocorticoid receptor antagonists percutaneous left ventricular assist devicesresynchronization (CRT) - defibrillators (ICD)cholesterol lowering interventionstatinsanticoagulantantithromboticsdirect oral anticoagulant (DAO)angiotensin-Converting Enzyme Inhibitorsangiotensin-receptor blockerscombined inhibition of ACE and neprilysininhibition of the renin-angiotensin system (ACEI or ARB)renin inhibitor anti inflammatory drugsantiarrythmic drugsbeta-blockerscalcium channel blockersdigitalis glycosidesExercise TherapyHR-slowing agentsincreasing hemoglobin concentration Miscellaneousnew drug under developmentphosphodiesterase III inhibitors relaxinevasodilators therapyvasopeptidase inhibitorvasopressin antagonist acute decompensated heart failureuncoded clinical condition ***all type of heart failureAll type of patientelderly patientsLeft Ventricular Dysfunction after Myocardial InfarctionMI patients with LV dysfunction without clinical evidence of HFpatients already receiving ACE inhibitorpatients already taking diureticspatients hospitalized for heart failurepatients intolerant to ACE inhibitorspatients previously untreated with ACE inhibitorspatients undergoing CABGpatients with non ichaemic cardiomyopathypatients with preserved-LVEF heart failurepost myocardial infarctionsurvivors of cardiac arrest       adenosine A1 receptor antagonistaldosterone-receptor blockersamiodaroneangiotensin receptor blockerAngiotensin-Converting Enzyme Inhibitorsanti-inflammatoryanticoagulantARBs added to ACEIbeta-blockersBNP-guided managementbone marrow derived stem cellcalcium-channel blockerscardiac resynchronization therapyCardiac stem cellsCombined CRT + ICDdevicedigoxindirect oral anticoagulantDiureticsdronedaroneepoprostenolerythropoeitinexercise traininggene therapyhuman B-type natriuretic peptidehydralazinehydralazine-ISDNImplantable cardioverter defibrillator therapyintravenous ironisosorbide dinitrateivabradineixmyelocel-TLow Molecular Weight Heparinmineralocorticoid receptor antagonistsmyoblastsoral vasopressin antagonistPhosphodiesterase III inhibitorsplatelet aggregation inhibitorsprazosinrelaxinestatinstelemonitoringvasopeptidase inhibitorventricular assist device atorvastatincerivastatinrosuvastatinsimvastatinamlodipinediltiazemfelodipinenicardipinenisoldipinecaptoprilenalaprilfosinoprillisinoprilperindoprilquinaprilramipriltrandolaprilirbesartanlosartantelmisartanvalsartancandesartanaliskiren amilorideamiodaroneamrinoneaspirinbenazeprilbisoprololbucindololcarvedilolcilazaprilclopidogreldigoxindronedaroneenoxaparinEnoximoneeplerenoneepoprostenolExercise TherapyFlosequinanfurosemidehydralazinehydralazine-ISDNhydrochlorothiazide ibopamineisosorbide dinitrateisradipineivabradinemetoprololmibefradilMilrinonenebivololnesiritideomapatrilatrivaroxabanrolofylline serelaxinspironolactonetaspoglutidetolvaptanvesnarinonewarfarin vs angiotensin receptor blockervs controlvs placebovs placebo or controlvs placebo or no treatmentvs usual carevs active treatmentvs angiotensin-converting enzyme inhibitorsvs antiplatelet drugsvs beta-blockersvs ezetimibevs ICDvs medical treatmentvs UFHvs vasodilatorsvs ventricular assist device      

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Group by Group by... nothing pathology treatment patient comparator classe classe comparator mechanism clinical condition MA  in first nothing pathology treatment patient comparator classe classe comparator mechanism clinical condition  in second nothing pathology treatment patient comparator classe classe comparator mechanism clinical condition  in third	Description Synopsis Comparison Treatments Patients Characteristics Method Risk of bias References None Tools Indexation					Results Global trial result Main results All results All result tag NCT results	All cause death (274)hospitalisation for heart failure (68)Death from any cause or hospitalization for any reason (67)Cardiovascular death (46)Sudden death (38)NYHA class improvement (35)Adverse events (34)exacerbation of heart failure (26)Hospitalization for any reason (19)Hypotension (14) (12)myocardial infarction (fatal and non fatal) (12)Worsening heart failure (11)cardiac death (10)Arrhythmia (10)Hyperkalaemia (9)Cough (9)angiodema (8)stroke (fatal and non fatal) (8)Vertigo (7)Cardiovascular death or hospital admission for CHF (7)acute heart failure (6)cardiovascular events (6)Major bleeding (6)hospitalisation for cardiovascular causes (6)serious hyperkalemia (6)heart failure death (6)Non fatal MI (5)Coronary event (5)Fatal stroke (5)Fatal MI (5)Non vascular death (5)new-onset diabetes (5)Long term death (5)death or hospitalization (5)Death from any cause or hospitalization for heart failure (5)Transplantation (4)NYHA deterioration (4)death from cardiovascular causes or hospitalization for cardiovascular causes (3)Non fatal stroke (3)death or cardiovascular hospitalization (3)All-cause hospitalisation (2)Adverse events leading to treatment discontinuation (2)Coronary death (2)death or nonfatal CHF events (2)death or severe congestive heart failure (1)CV death, MI hospitalization for HF (1)amelioration of Dyspnea at 24 h (1)30-day death (1) Options Numeric bar chart forest plot medians
Trial	Studied trt	Control trt	patients	tags	ROB	Trial result	All cause death	hospitalisation for heart failure
aldosterone blockade
eplerenone
EPHESUS, 2003	eplerenone	placebo			Low risk of bias	suggesting
EMPHASIS-HF, 2010        NCT	eplerenone	placebo			Low risk of bias	suggesting
spironolactone
Cicoira, 2004	spironolactone	control				-
Cicoira, 2002	spironolactone	control			Exploratory	-
Ramires, 2000	spironolactone	control			Exploratory	-
RALES, 1998	spironolactone	placebo			Risk of bias	suggesting
Agostoni, 2005	spironolactone	placebo			Exploratory	-
Mottram, 2004	spironolactone	placebo			Low risk of bias	-
Macdonald, 2004	spironolactone	placebo			Low risk of bias	-
Yee, 2001	spironolactone	placebo			Low risk of bias	-
Tsutamoto, 2001	spironolactone	placebo			Low risk of bias	-
Farquharson, 2000	spironolactone	placebo			Low risk of bias	-
MacFadyen, 1997	spironolactone	placebo			Low risk of bias	-
Han, 1994	spironolactone+captopril	captopril			Exploratory	-
Bednarz, 2000	aldactone	furosemide			Exploratory	-
Mauersberger, 1985	spironolactone+furosemide	spironolactone+butizide			Exploratory	-
angiotensin-Converting Enzyme Inhibitors
not classified
CASSIS (spirapril), 1995	spirapril	placebo			Low risk of bias	-
benazepril
McGany, 1991	benazepril	control				negative
Colfer, 1992	benazepril	placebo			Low risk of bias	negative
captopril
Magnani, 1986	captopril	placebo			Low risk of bias	-
Bussmann, 1987	captopril	placebo			Low risk of bias	negative
Captopril Digoxin Multicenter Research Group, 1988	captopril	placebo			Low risk of bias	negative
Barabino, 1991	captopril	placebo			Low risk of bias	suggesting
Munich MHFT (Kleber), 1992	captopril	placebo			Low risk of bias	negative
Magnani, 1990	captopril	placebo			Low risk of bias	-
CMRG, 1983	captopril	placebo			Low risk of bias	-
Cilazapril-Captopril Multi-centre Group (capt vs pbo), 1995	captopril	placebo			Low risk of bias	-
SAVE, 1992	captopril	placebo			Low risk of bias	-
Pfeffer, 1988	captopril	placebo			Low risk of bias	-
Sogaard, 1994	captopril	placebo			Low risk of bias	-
Sharpe, 1988	captopril	placebo			Low risk of bias	-
Mortarino, 1990	captopril	placebo			Low risk of bias	-
packer, 1986	captopril	enalapril			Exploratory	-
cilazapril
Drexler, 1989	cilazapril	placebo			Low risk of bias	negative
Dosseger, 1993	cilazapril	placebo			Low risk of bias	-
Cilazapril-Captopril Multi-centre Group, 1995	cilazapril	placebo			Low risk of bias	-
Cilazapril-Captopril Multi-centre Group (cila vs capt), 1995	cilazapril	captopril			Low risk of bias	-
enalapril
Rucinska-b (enalapril), 1991	enalapril	control				negative
Enalapril CHF investigators, 1987	enalapril	control				negative
Rucinska-a (enalapril), 1991	enalapril	control				negative
SOLVD treatment, 1991    NCT	enalapril	placebo			Low risk of bias	suggesting
SOLVD prevention, 1992    NCT	enalapril	placebo			Low risk of bias	-
Cleland, 1985	enalapril	placebo			Low risk of bias	negative
CONSENSUS, 1987	enalapril	placebo			Low risk of bias	negative
Dickstein, 1991	enalapril	placebo			Low risk of bias	negative
Sharpe, 1984	enalapril	placebo			Low risk of bias	-
McGrath, 1985	enalapril	placebo			Low risk of bias	-
Chrysant, 1985	enalapril	placebo			Low risk of bias	-
CASSIS (enalapril), 1995	enalapril	placebo			Low risk of bias	-
NETWORK (2.5 bid vs 10 bid), 1998	enalapril	enalapril			Low risk of bias	-
NETWORK (5 bid vs 10 bid), 1998	enalapril	enalapril			Low risk of bias	-
V-HeFT II, 1991	enalapril	hydralazine+ISDN			Low risk of bias	-
fosinopril
Brown, 1995	fosinopril	placebo			Low risk of bias	-
FEST (Erhardt), 1996	fosinopril	placebo			Low risk of bias	-
lisinopril
Zwehl, 1990	lisinopril	control				negative
Giles, 1990	lisinopril	control				negative
Rucinska-c (lisinopril), 1000	lisinopril	control				negative
Gilbert, 1993	lisinopril	placebo			Low risk of bias	negative
International Study Group (Lewis), 1989	lisinopril	placebo			Low risk of bias	-
ATLAS, 1999	lisinopril	lisinopril			Low risk of bias	-
perindopril
Lechat, 1993	perindopril	placebo			Low risk of bias	negative
PEP CHF, 2006	perindopril	placebo			Low risk of bias	negative
quinapril
Uprichard-a, 1994		control				negative
Uprichard-b, 1994		control				negative
Uprichard-c, 1994		control				negative
Riegger, 1990		placebo			Low risk of bias	negative
Northridge, 1991		placebo			Low risk of bias	negative
Rieger, 1991		placebo			Low risk of bias	negative
Nussberger, 1994		placebo			Low risk of bias	-
Quinapril Heart Failure Trial Investigators, 1993		placebo			Low risk of bias	-
ramipril
Swedberg, 1991	ramipril	control				negative
Maass-a, 1991	ramipril	placebo				negative
Gordon, 1991	ramipril	placebo			Low risk of bias	suggesting
Maass-b, 1991	ramipril	placebo			Low risk of bias	negative
Maass-c, 1991	ramipril	placebo			Low risk of bias	negative
Lemarie, 1992	ramipril	placebo			Low risk of bias	negative
Gundersen, 1994	ramipril	placebo			Low risk of bias	-
AIRE, 1993	ramipril	placebo			Low risk of bias	-
trandolapril
Hampton, 1998	trandolapril	placebo			Low risk of bias	-
TRACE, 1995	trandolapril	placebo			Low risk of bias	-
angiotensin-receptor blockers
not classified
ADEPT, 2001	eprosartan+ACE inhibitor	ACE inhibitor only			Low risk of bias	-
candesartan
ARCH-J, 2003	candesartan	placebo			Low risk of bias	-
CHARM-Alternative, 2003	candesartan	placebo			Low risk of bias	suggesting
Mitrovic et al., 2003	candesartan	placebo			Low risk of bias	suggesting
SPICE, 2000	candesartan	placebo			Low risk of bias	negative
STRETCH, 1999	candesartan	placebo			Low risk of bias	-
CHARM preserved, 2003	candesartan	placebo			Low risk of bias	-
CHARM-Added, 2003	candesartan+ACE inhibitor	ACE inhibitor only			Low risk of bias	negative
RESOLVD association, 1999	candesartan+ACE inhibitor	ACE inhibitor only			Exploratory	negative
RESOLVD (candesartan alone), 1999	candesartan	enalapril			Low risk of bias	negative
irbesartan
I-PRESERVE (McMurray), 2008      NCT	ibesartan	placebo			Low risk of bias	negative
Tonkon et al., 2000	irbesartan+ACE inhibitor	ACE inhibitor only			Low risk of bias	-
losartan
HEAAL, 2009        NCT	losartan 150mg	losartan 50mg			Low risk of bias	suggesting
Losartan Phase III International, 1996	losartan	placebo			Low risk of bias	suggesting
Losartan Phase III U.S., 1995	losartan	placebo			Low risk of bias	negative
Hamroff et al., 1999	losartan+ACE inhibitor	ACE inhibitor only			Low risk of bias	-
ELITE, 1997	losartan	captopril			Low risk of bias	negative
ELITE II, 2000	losartan	captopril			Low risk of bias	-
Dickstein et al., 1995	losartan	enalapril			Low risk of bias	-
Lang et al., 1997	losartan	enalapril			Low risk of bias	-
Losartan phase II S, 1996	losartan	enalapril			Low risk of bias	-
losartan phase II US, 1996	losartan	enalapril			Low risk of bias	-
telmisartan
REPLACE, 2001	telmisartan	enalapril			Low risk of bias	-
valsartan
VALIDD, 2007    NCT	valsartan	no valsartan			Low risk of bias	negative
Mazayev et al. (vs placebo), 1998	valsartan	placebo			Low risk of bias	-
V-HeFT, 1999	valsartan+ACE inhibitor	ACE inhibitor only			Low risk of bias	negative
Val-HeFT, 2001	valsartan+ACE inhibitor	ACE inhibitor only			Low risk of bias	suggesting
HEAVEN, 2002	valsartan	enalapril			Low risk of bias	-
Mazayev et al. (vs lisinopril, 1998	valsartan	Lisinopril			Exploratory	-
anti inflammatory drugs
not classified
ACCLAIM, 2008      NCT	Celacade™ system	placebo			Low risk of bias	negative
antiarrythmic drugs
amiodarone
EPAMSA, 1985	amiodarone	no treatment				suggesting
GESICA, 1994	amiodarone	no treatment				suggesting
Hamer, 1989	amiodarone	placebo			Low risk of bias	suggesting
Nicklas, 1991	amiodarone	placebo			Low risk of bias	negative
STATCHF, 1995	amiodarone	placebo			Low risk of bias	negative
AMIOVIRT, 2003	amiodarone	ICD				negative
dronedarone
ANDROMEDA, 2008      NCT	dronedarone	placebo			Low risk of bias	negative
anticoagulant
rivaroxaban
COMMANDER HF, 2018      NCT	rivaroxaban	placebo				negative
warfarin
HELAS (warfarin vs placebo), 2006	warfarin	placebo			Low risk of bias	-
HELAS (warfarin vs aspirin), 2006	warfarin	aspirin			Low risk of bias	-
WATCH (warfarin vs aspirin), 2009      NCT	warfarin	aspirin				suggesting
antithrombotics
not classified
Barzizza (A+D), 1993		placebo				-
aspirin
WASH (aspirin), 2004	aspirin	no treatment				negative
Barzizza (ASA), 1993	aspirin	placebo			Exploratory	-
enoxaparin
THE-PRINCE (Kleber), 2003	enoxaparin	UFH				-
rivaroxaban
COMMANDER HF, 2018      NCT	rivaroxaban	placebo				negative
warfarin
WASH (warfarin), 2004	warfarin	no treatment				negative
HELAS (warfarin vs placebo), 2006	warfarin	placebo			Low risk of bias	-
Barzizza (warfarin), 1993	warfarin	placebo				-
HELAS (warfarin vs aspirin), 2006	warfarin	aspirin			Low risk of bias	-
WATCH (warfarin vs aspirin), 2009      NCT	warfarin	aspirin				suggesting
beta-blockers
bisoprolol
CIBIS, 1994	bisoprolol	placebo			Low risk of bias	suggesting
CIBIS II, 1999	bisoprolol	placebo			Low risk of bias	suggesting
CIBIS II (elderly subgroup), 1999	Bisoprolol	placebo				suggesting
bucindolol
BEST, 2001    NCT	bucindolol	placebo			Low risk of bias	suggesting
Pollock, 1990	Bucindolol	placebo			Low risk of bias	-
Woodley, 1991	Bucindolol	placebo				-
Bristow, 1994	Bucindolol	placebo				-
MERIT-HF (elderly subgroup), 1999	Bucindolol	placebo				suggesting
carvedilol
ANZ-HeFT, 1997	carvedilol	placebo			Low risk of bias	negative
COPERNICUS, 2002	carvedilol	placebo			Low risk of bias	suggesting
CAPRICORN, 2001	carvedilol	placebo			Low risk of bias	suggesting
Metra, 1994	carvedilol	placebo				-
Olsen, 1995	carvedilol	placebo				-
Krum, 1995	carvedilol	placebo				-
Bristow (MOCHA), 1996	carvedilol	placebo			Low risk of bias	-
Parker, 1996	carvedilol	placebo			Low risk of bias	negative
Colucci, 1996	carvedilol	placebo			Low risk of bias	-
Cohn, 1997	carvedilol	placebo				-
Carvedilol U.S. Trials (elderly subgroup), 1996	Carvedilol	placebo				suggesting
COPERNICUS (elderly subgroup), 2001	Carvedilol	placebo				suggesting
CARMEN (carvedilol alone), 2004	carvedilol	enalapril				negative
COMET, 2003	carvedilol	metoprolol			Low risk of bias	suggesting
metoprolol
MDC (Waagstein), 1993	metoprolol	placebo			Low risk of bias	negative
MERIT-HF, 1999	metoprolol	placebo			Low risk of bias	suggesting
Engelmeier, 1985	metoprolol	placebo				-
Fisher, 1994	metoprolol	placebo				-
Eichhorn, 1994	metoprolol	placebo				-
RESOLVD, 2000	metoprolol	placebo				-
BEST (elderly subgroup), 2001	Metoprolol	placebo				negative
nebivolol
Lechat, 1991	Nebivolol	placebo				-
Wisenbaugh, 1993	Nebivolol	placebo			Low risk of bias	negative
SENIORS, 2005	nebivolol	placebo			Low risk of bias	-
BNP guided management
not classified
TIME CHF, 2009	BNP-guided management	control			Risk of bias	negative
PRIMA	BNP-guided management	control			Risk of bias	negative
PROTECT, 2009    NCT	BNP-guided management	control				-
STARS-BNP, 2007	BNP-guided management	control			Risk of bias	suggesting
BATTLESCARRED, 2009	BNP-guided management	control			Risk of bias	negative
STARBRITE, 2007    NCT	BNP-guided management	control				-
Troughton, 2000	BNP-guided management	control			Risk of bias	suggesting
calcium channel blockers
not classified
De Vries, 1996		placebo			Low risk of bias	-
amlodipine
Packer, 1991	amlodipine	control			Low risk of bias	-
Smith, 1994	amlodipine	control			Low risk of bias	-
Udelson, 1996	amlodipine	control			Low risk of bias	-
Binkley, 1996	amlodipine	control			Low risk of bias	-
Ghali, 1997	amlodipine	control			Low risk of bias	-
PRAISE, 1996	amlodipine	placebo			Low risk of bias	negative
PRAISE II , 2000	Amlodipine	placebo			Low risk of bias	negative
diltiazem
Liao , 1998	Diltiazem	placebo			Exploratory	suggesting
DiDi, 1996	diltiazem	placebo			Low risk of bias	negative
felodipine
VHeFT III, 1997	felodipine	placebo			Low risk of bias	negative
Kassis, 1987	felodipine	placebo			Low risk of bias	-
Littler, 1995	Felodipine	placebo			Low risk of bias	negative
Kassis, 1990	felodipine	placebo			Low risk of bias	-
Dunselman, 1990	felodipine	enalapril			Low risk of bias	-
De Vries, 1995	felodipine	enalapril			Low risk of bias	-
isradipine
Van den Toren, 1996	isradipine	placebo			Low risk of bias	-
mibefradil
MACH 1, 2000	mibefradil	placebo			Low risk of bias	suggesting
nicardipine
Gheorghiade, 1991	nicardipine	control			Low risk of bias	-
Abrams, 1993	nicardipine	control			Low risk of bias	-
nisoldipine
Gaudron, 1996	Nisoldipine	placebo			Exploratory	-
Rousseau, 1994	nisoldipine	placebo			Low risk of bias	-
Schofer, 1990	nisoldipine	captopril			Low risk of bias	-
cell-based therapies
not classified
Revive						-
POSEIDON, 2012      NCT	Mesenchymal stem cells	allogeneic mesenchymal stem cells				-