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Safety and efficacy of rennin-angiotensin system inhibitors in heart failure with preserved ejection fraction

Author(s): Mukesh Singh | Tejaskumar Shah | Sasikanth Adigopula, | Sandeep Khosla, | Rohit Arora, | Evyan Jawad

Journal: International Journal of Collaborative Research on Internal Medicine & Public Health
ISSN 1840-4529

Volume: 3;
Issue: 3;
Start page: 244;
Date: 2011;
Original page

Keywords: ACE inhibitor | Angiotensin receptor blocker | Heart failure with preserved ejection fraction

Background: Approximately half of the patients with chronic heart failure have preserved left ventricularsystolic function. The trials of rennin-angiotensin system inhibitors (RASIs) in this population haveyielded mixed results. We performed a meta-analysis of these trials to evaluate the safety and efficacy ofRASIs in heart failure with preserved ejection fraction patients.Methods: A total of 8425 patients from six prospective randomized controlled trials were analyzed. Theend points extracted were total mortality, cardiovascular mortality, hospitalization for heart failure,worsening of heart failure, worsening of renal failure, hyperkalemia, hypotension, six minute walk test,quality of life score. RASIs evaluated were perindopril, enalapril, ramipril, valsartan, candesartan andirbesartan. Combined odds ratios (OR) across all the studies and 95% confidence intervals (CI) werecomputed. A two-sided alpha error

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