This study aimed to investigate the short‐term efficacy and safety of tolvaptan as an add‐on to traditional diuretics in patients with acute heart failure (AHF). The PubMed, EMBASE, Cochrane Library, and Web of Science databases were comprehensively searched for all randomized controlled trials (RCTs) that examined AHF patients treated with tolvaptan as a combination therapy with traditional diuretics published on or before December 2, 2019. Efficacy indicators such as improved dyspnea, reduced edema, and changes in urine output and body weight were evaluated. In‐hospital mortality and worsening renal function (WRF) were measured as safety indicators. Data from the published literature included in this study were independently extracted by two reviewers. The Cochrane risk of bias tool was used to evaluate the quality of the included RCTs. Twelve RCTs involving 5577 patients admitted for AHF were included. Compared with traditional diuretics alone, add‐on tolvaptan significantly relieved dyspnea, reduced weight, increased total urine volume and changes in urine volume from baseline, reduced edema, and increased serum sodium concentration in the short term without increasing the mortality. Most importantly, a low dose of tolvaptan (7.5‐15 mg/d) significantly reduced the incidence of WRF, while a high dose (30 mg/d) had the opposite effect. Short‐term add‐on tolvaptan in hospitalized AHF patients could significantly relieve shortness of breath, reduce body weight, improve edema, and increase urine output and serum sodium concentrations without increasing mortality. The protective effects of add‐on tolvaptan against WRF, however, were observed at low doses, but not at high doses.
The above article, published online on 05 May 2014 in Wiley Online Library (http://onlinelibrary.wiley.com/doi/10.1002/cbin.10291/full), has been retracted by agreement between the authors, the journal Editor, Sergio Schenkman, and John Wiley & Sons Ltd. The retraction has been agreed because the authors discovered that the results of section 3 in this paper were irreproducible. In addition, Zhiqiang Yang, a co-author, states conflict of interest in this paper. The authors and publisher apologize for any inconvenience. Reference Luo X, Yang Z, Zheng S, Cao Y, Wu Y (2014) Sirt3 activation attenuated oxidized low-density lipoprotein induced human umbilical vein endothelial cells' apoptosis by sustaining autophagy. Cell Biol Int, https://doi.org/10.1002/cbin.10291.
Background: This meta-analysis is to evaluate the efficacy and safety of bivalirudin in patients with ST-elevation myocardial infarction (STEMI). Methods: PubMed, Cochrane Library, Embase, CNKI, CBMdisc, and VIP database were searched. Randomized controlled trial (RCT) was selected and the meta-analysis was conducted by RevMan 5.1. The primary efficacy endpoint was the incidence of major adverse cardiovascular events (MACE) and the primary safety endpoint was the incidence of major bleeding. Secondary efficacy endpoints were myocardial infarction (MI), target vessel revascularization (TVR), stent thrombosis (ST), stock, mortality, and thrombocytopenia. The pooled risk ratios (RRs) with the corresponding 95% confidence intervals (CI) were used to assess the efficacy and safety of bivalirudin vs heparin. Results: Seven RCTs met the inclusion criteria, and 16,640 patients were included. We found that bivalirudin associated with lower risk of mortality (RR = 1.05; 95% CI = 0.74–1.49; P = .03; I 2 = 2%), major bleeding (RR = 0.64; 95% CI = 0.54–0.75; P < .00001; I 2 = 70%) and thrombocytopenia (RR = 0.39; 95% CI = 0.25–0.61; P < .0001; I 2 = 0) compared with heparin. However, the use of bivalirudin increase the risk of MI(RR = 1.37; 95% CI = 1.10–1.71; P = .004; I 2 = 25%) and ST(RR = 1.61; 95% CI = 1.05–2.47; P = .03; I 2 = 70%) and has similar risk of MACE (RR = 1.00; 95% CI = 0.90–1.11; P = .97; I 2 = 16%), TVR (RR = 1.43; 95% CI = 0.92–2.22; P = .11; I 2 = 46%) and stock (RR = 1.43; 95% CI = 0.92–2.22; P = .11; I 2 = 46%) compared with heparin used in STEMI patients. Conclusion: Bivalirudin associated with lower risk of mortality, major bleeding and thrombocytopenia compared with heparin. However, the use of bivalirudin increase the risk of MI and ST and has similar risk of MACE, TVR and stock compared with heparin used in STEMI patients.
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