본문 바로가기
HOME> 논문 > 논문 검색상세

논문 상세정보

The American heart journal v.195, 2018년, pp.60 - 69   SCI SCIE
본 등재정보는 저널의 등재정보를 참고하여 보여주는 베타서비스로 정확한 논문의 등재여부는 등재기관에 확인하시기 바랍니다.

Mineralocorticoid receptor antagonists in patients with acute myocardial infarction — A systematic review and meta-analysis of randomized trials

Bossard, Matthias (Population Health Research Institute, McMaster University, Hamilton Health Sciences, 237 Barton St E, Hamilton, Ontario, Canada ) ; Binbraik, Yasser (Division of General Internal Medicine, Hamilton Health Sciences, McMaster University, Juravinski Site, 711 Concession St, Hamilton, Ontario, Canada ) ; Beygui, Farzin (Cardiology Division, Centre Hospitalier Universitaire de Caen, Ave de la Côte de Nacre, Caen, France ) ; Pitt, Bertram (University of Michigan School of Medicine, University of Michigan, University of Michigan Health System, 1500 E Medical Center Dr #6303, Ann Arbor, MI ) ; Zannad, Faiez (INSERM CIC 1433, Université ) ; Montalescot, Gilles (de Lorraine and CHRU, Nancy, Hôpital Brabois, Bâtiment Louis mathieu, Vandoeuvre-Les-Nancy, France ) ; Jolly, Sanjit S. (Université ) ;
  • 초록  

    Background Although mineralocorticoid antagonists (MRAs) reduce mortality in patients with heart failure complicating myocardial infarction (MI), it is unclear if they could be beneficial to all patients with MI. To evaluate the utility of MRAs in MI patients, we performed a systematic review and meta-analysis. Methods MEDLINE, EMBASE, and Cochrane CENTRAL were searched from 1965 to June 2016. Conference abstracts were searched from 2000 to June 2016. Randomized trials evaluating the effect of MRA after MIs were included. Two reviewers independently extracted data and assessed study quality. Data were combined using fixed-/random-effects models. Results Eleven randomized clinical trials (N = 11,258) were included; 1 trial (N = 6,642) included patients with apparent heart failure (Killip class III-IV). Administration of MRA versus placebo or standard therapy (no-MRA) after MI reduced overall and cardiovascular mortality (odds ratio [OR] 0.82, 95% CI 0.73-0.93, P = .002, and OR 0.82, 95% CI 0.71-0.93, P = .003, respectively; I 2 for both = 0%). In the subgroup of trials with patients with heart failure, the mortality was 14.4% in MRA group versus 16.7% in no-MRA group (OR 0.84, 95% CI 0.73-0.96), and among those without heart failure, it was 2.5% with MRA versus 3.5% without MRA (OR 0.72, 95% CI 0.51-1.02, P for interaction = .43). Patients receiving MRA had fewer new or worsening heart failure events (OR 0.74, 95% CI 0.66-0.84, P I 2 = 14%). Nevertheless, MRA therapy increased risk for hyperkalemia (≥5.5 mmol/L) (OR 2.52, 95% CI 1.36-4.65, P = .003; I 2 = 63%). Conclusions Administration of MRA may reduce mortality after acute MI. However, this is largely based on post-MI patients with heart failure. Further data are needed in MI patients without heart failure.


 활용도 분석

  • 상세보기

    amChart 영역
  • 원문보기

    amChart 영역

원문보기

무료다운로드
  • 원문이 없습니다.

유료 다운로드의 경우 해당 사이트의 정책에 따라 신규 회원가입, 로그인, 유료 구매 등이 필요할 수 있습니다. 해당 사이트에서 발생하는 귀하의 모든 정보활동은 NDSL의 서비스 정책과 무관합니다.

원문복사신청을 하시면, 일부 해외 인쇄학술지의 경우 외국학술지지원센터(FRIC)에서
무료 원문복사 서비스를 제공합니다.

NDSL에서는 해당 원문을 복사서비스하고 있습니다. 위의 원문복사신청 또는 장바구니 담기를 통하여 원문복사서비스 이용이 가능합니다.

이 논문과 함께 출판된 논문 + 더보기