Assessing the risk of angiotensin receptor blockers on major cardiovascular events: a systematic review and meta-analysis of randomized controlled trials
<h3>Background</h3><p dir="ltr">Angiotensin receptor blockers (ARBs) are commonly used as a treatment for many cardiovascular diseases, but their safety has been called into question. The VALUE trial found an increased risk of myocardial infarction in participants receivi...
محفوظ في:
| المؤلف الرئيسي: | |
|---|---|
| مؤلفون آخرون: | , , |
| منشور في: |
2020
|
| الموضوعات: | |
| الوسوم: |
إضافة وسم
لا توجد وسوم, كن أول من يضع وسما على هذه التسجيلة!
|
| _version_ | 1864513550080278528 |
|---|---|
| author | Yara Wanas (8744844) |
| author2 | Rim Bashir (8744847) Nazmul Islam (14153049) Luis Furuya-Kanamori (477124) |
| author2_role | author author author |
| author_facet | Yara Wanas (8744844) Rim Bashir (8744847) Nazmul Islam (14153049) Luis Furuya-Kanamori (477124) |
| author_role | author |
| dc.creator.none.fl_str_mv | Yara Wanas (8744844) Rim Bashir (8744847) Nazmul Islam (14153049) Luis Furuya-Kanamori (477124) |
| dc.date.none.fl_str_mv | 2020-04-21T21:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1186/s12872-020-01466-5 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Assessing_the_risk_of_angiotensin_receptor_blockers_on_major_cardiovascular_events_a_systematic_review_and_meta-analysis_of_randomized_controlled_trials/21598293 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Cardiovascular medicine and haematology Pharmacology and pharmaceutical sciences Cardiovascular events Angiotensin receptor blockers Meta-analysis Risk |
| dc.title.none.fl_str_mv | Assessing the risk of angiotensin receptor blockers on major cardiovascular events: a systematic review and meta-analysis of randomized controlled trials |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Background</h3><p dir="ltr">Angiotensin receptor blockers (ARBs) are commonly used as a treatment for many cardiovascular diseases, but their safety has been called into question. The VALUE trial found an increased risk of myocardial infarction in participants receiving ARBs compared to other antihypertensive. The aim of the meta-analysis was to synthetize the available evidence of randomised controlled trials (RCTs) and elucidate if ARBs increase the risk of cardiovascular events.</p><h3>Methods</h3><p dir="ltr">A comprehensive search was conducted to identify RCTs that assessed the safety of ARBs. Titles and abstracts of all papers were independently screened by two authors. Data extraction and quality assessment were also performed independently. The relative risk (RR) of all-cause mortality, myocardial infarction, and stroke were pooled using the IVhet model. Multiple sensitivity analyses were conducted to assess the effect of ARBs by restricting the analysis to different participants’ characteristics.</p><h3>Results</h3><p dir="ltr">Forty-five RCTs comprising of 170,794 participants were included in the analysis. The pooled estimates revealed that ARBs do not increase the risk of all-cause mortality (RR 1.00; 95%CI 0.97–1.04), myocardial infarction (RR 1.01; 95%CI 0.96–1.06), and stroke (RR 0.92; 95%CI 0.83–1.01). The sensitivity analysis did not yield a particular group of patients at increased risk of cardiovascular events with ARBs. Risk of all-cause mortality and stroke decreased with ARB when the proportion of smokers in a population was < 25% (RR 0.91; 95%CI 0.84–0.98) and in females (RR 0.76; 95%CI 0.68–0.84), respectively.</p><h3>Conclusions</h3><p dir="ltr">ARBs do not increase the risk of major cardiovascular events and are safe for use in patients.</p><h2>Other Information</h2><p dir="ltr">Published in: BMC Cardiovascular Disorders<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1186/s12872-020-01466-5" target="_blank">http://dx.doi.org/10.1186/s12872-020-01466-5</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_860afda92b00363cb4ddbcd1c9fd9a6c |
| identifier_str_mv | 10.1186/s12872-020-01466-5 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/21598293 |
| publishDate | 2020 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Assessing the risk of angiotensin receptor blockers on major cardiovascular events: a systematic review and meta-analysis of randomized controlled trialsYara Wanas (8744844)Rim Bashir (8744847)Nazmul Islam (14153049)Luis Furuya-Kanamori (477124)Biomedical and clinical sciencesCardiovascular medicine and haematologyPharmacology and pharmaceutical sciencesCardiovascular eventsAngiotensin receptor blockersMeta-analysisRisk<h3>Background</h3><p dir="ltr">Angiotensin receptor blockers (ARBs) are commonly used as a treatment for many cardiovascular diseases, but their safety has been called into question. The VALUE trial found an increased risk of myocardial infarction in participants receiving ARBs compared to other antihypertensive. The aim of the meta-analysis was to synthetize the available evidence of randomised controlled trials (RCTs) and elucidate if ARBs increase the risk of cardiovascular events.</p><h3>Methods</h3><p dir="ltr">A comprehensive search was conducted to identify RCTs that assessed the safety of ARBs. Titles and abstracts of all papers were independently screened by two authors. Data extraction and quality assessment were also performed independently. The relative risk (RR) of all-cause mortality, myocardial infarction, and stroke were pooled using the IVhet model. Multiple sensitivity analyses were conducted to assess the effect of ARBs by restricting the analysis to different participants’ characteristics.</p><h3>Results</h3><p dir="ltr">Forty-five RCTs comprising of 170,794 participants were included in the analysis. The pooled estimates revealed that ARBs do not increase the risk of all-cause mortality (RR 1.00; 95%CI 0.97–1.04), myocardial infarction (RR 1.01; 95%CI 0.96–1.06), and stroke (RR 0.92; 95%CI 0.83–1.01). The sensitivity analysis did not yield a particular group of patients at increased risk of cardiovascular events with ARBs. Risk of all-cause mortality and stroke decreased with ARB when the proportion of smokers in a population was < 25% (RR 0.91; 95%CI 0.84–0.98) and in females (RR 0.76; 95%CI 0.68–0.84), respectively.</p><h3>Conclusions</h3><p dir="ltr">ARBs do not increase the risk of major cardiovascular events and are safe for use in patients.</p><h2>Other Information</h2><p dir="ltr">Published in: BMC Cardiovascular Disorders<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1186/s12872-020-01466-5" target="_blank">http://dx.doi.org/10.1186/s12872-020-01466-5</a></p>2020-04-21T21:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1186/s12872-020-01466-5https://figshare.com/articles/journal_contribution/Assessing_the_risk_of_angiotensin_receptor_blockers_on_major_cardiovascular_events_a_systematic_review_and_meta-analysis_of_randomized_controlled_trials/21598293CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/215982932020-04-21T21:00:00Z |
| spellingShingle | Assessing the risk of angiotensin receptor blockers on major cardiovascular events: a systematic review and meta-analysis of randomized controlled trials Yara Wanas (8744844) Biomedical and clinical sciences Cardiovascular medicine and haematology Pharmacology and pharmaceutical sciences Cardiovascular events Angiotensin receptor blockers Meta-analysis Risk |
| status_str | publishedVersion |
| title | Assessing the risk of angiotensin receptor blockers on major cardiovascular events: a systematic review and meta-analysis of randomized controlled trials |
| title_full | Assessing the risk of angiotensin receptor blockers on major cardiovascular events: a systematic review and meta-analysis of randomized controlled trials |
| title_fullStr | Assessing the risk of angiotensin receptor blockers on major cardiovascular events: a systematic review and meta-analysis of randomized controlled trials |
| title_full_unstemmed | Assessing the risk of angiotensin receptor blockers on major cardiovascular events: a systematic review and meta-analysis of randomized controlled trials |
| title_short | Assessing the risk of angiotensin receptor blockers on major cardiovascular events: a systematic review and meta-analysis of randomized controlled trials |
| title_sort | Assessing the risk of angiotensin receptor blockers on major cardiovascular events: a systematic review and meta-analysis of randomized controlled trials |
| topic | Biomedical and clinical sciences Cardiovascular medicine and haematology Pharmacology and pharmaceutical sciences Cardiovascular events Angiotensin receptor blockers Meta-analysis Risk |