Comparison of diuretic strategies in diuretic-resistant acute heart failure: A systematic review and network meta-analysis

D. Orso; G. Tavazzi; F. Corradi; F. Mearelli; N. Federici; D. Peric; N. D’Andrea; G. Santori; F. Mojoli; F. Forfori; L. Vetrugno; T. Bove

doi:10.26355/eurrev_202104_25550

Comparison of diuretic strategies in diuretic-resistant acute heart failure: A systematic review and network meta-analysis

D. Orso, G. Tavazzi, F. Corradi, F. Mearelli, N. Federici, D. Peric, N. D’Andrea, G. Santori, F. Mojoli, F. Forfori, L. Vetrugno, T. Bove

Research output: Contribution to journal › Review article › peer-review

Abstract

OBJECTIVE: Up to 50% of patients hospitalized for acute heart failure (AHF) show resistance to diuretics. This condition contributes to a prolonged hospital length of stay and a higher risk of death. This review aimed to investigate whether a diuretic therapeutic approach more effective than furosemide alone exists for patients with diuretic-resistant AHF. MATERIALS AND METHODS: We identified all randomized controlled trials (RCTs) evaluating diuretic therapy in patients with diuretic-resistant AHF. We searched Pubmed, BioMed Central, and Cochrane CENTRAL databases. RESULTS: Six RCTs were identified, involving a total of 845 patients. The P-score ranges from 0.6663 for furosemide to 0.2294 for the tolvaptan-furosemide. We found no significant differences in efficacy for any drug comparison. CONCLUSIONS: None of the diuretics considered in RCTs performed to date (tolvaptan, metolazone, hydrochlorothiazide, indapamide) appear to be more effective than furosemide therapy alone for the treatment of patients with diuretic-resistant AHF.

Original language	English
Pages (from-to)	2971-2980
Number of pages	10
Journal	European Review for Medical and Pharmacological Sciences
Volume	25
Issue number	7
DOIs	https://doi.org/10.26355/eurrev_202104_25550
Publication status	Published - 2021

Keywords

Acute heart failure
Diuretic resistance
Efficacy
Furosemide
Network meta-analysis
Tolvaptan

ASJC Scopus subject areas

Pharmacology (medical)

Access to Document

10.26355/eurrev_202104_25550

Cite this

Orso, D., Tavazzi, G., Corradi, F., Mearelli, F., Federici, N., Peric, D., D’Andrea, N., Santori, G., Mojoli, F., Forfori, F., Vetrugno, L., & Bove, T. (2021). Comparison of diuretic strategies in diuretic-resistant acute heart failure: A systematic review and network meta-analysis. European Review for Medical and Pharmacological Sciences, 25(7), 2971-2980. https://doi.org/10.26355/eurrev_202104_25550

Orso, D, Tavazzi, G, Corradi, F, Mearelli, F, Federici, N, Peric, D, D’Andrea, N, Santori, G, Mojoli, F, Forfori, F, Vetrugno, L & Bove, T 2021, 'Comparison of diuretic strategies in diuretic-resistant acute heart failure: A systematic review and network meta-analysis', European Review for Medical and Pharmacological Sciences, vol. 25, no. 7, pp. 2971-2980. https://doi.org/10.26355/eurrev_202104_25550

@article{1d3644716aaf4b21a811a09a09be99e0,

title = "Comparison of diuretic strategies in diuretic-resistant acute heart failure: A systematic review and network meta-analysis",

abstract = "OBJECTIVE: Up to 50% of patients hospitalized for acute heart failure (AHF) show resistance to diuretics. This condition contributes to a prolonged hospital length of stay and a higher risk of death. This review aimed to investigate whether a diuretic therapeutic approach more effective than furosemide alone exists for patients with diuretic-resistant AHF. MATERIALS AND METHODS: We identified all randomized controlled trials (RCTs) evaluating diuretic therapy in patients with diuretic-resistant AHF. We searched Pubmed, BioMed Central, and Cochrane CENTRAL databases. RESULTS: Six RCTs were identified, involving a total of 845 patients. The P-score ranges from 0.6663 for furosemide to 0.2294 for the tolvaptan-furosemide. We found no significant differences in efficacy for any drug comparison. CONCLUSIONS: None of the diuretics considered in RCTs performed to date (tolvaptan, metolazone, hydrochlorothiazide, indapamide) appear to be more effective than furosemide therapy alone for the treatment of patients with diuretic-resistant AHF.",

keywords = "Acute heart failure, Diuretic resistance, Efficacy, Furosemide, Network meta-analysis, Tolvaptan",

author = "D. Orso and G. Tavazzi and F. Corradi and F. Mearelli and N. Federici and D. Peric and N. D{\textquoteright}Andrea and G. Santori and F. Mojoli and F. Forfori and L. Vetrugno and T. Bove",

year = "2021",

doi = "10.26355/eurrev_202104_25550",

language = "English",

volume = "25",

pages = "2971--2980",

journal = "European Review for Medical and Pharmacological Sciences",

issn = "1128-3602",

publisher = "Verduci Editore",

number = "7",

}

TY - JOUR

T1 - Comparison of diuretic strategies in diuretic-resistant acute heart failure

T2 - A systematic review and network meta-analysis

AU - Orso, D.

AU - Tavazzi, G.

AU - Corradi, F.

AU - Mearelli, F.

AU - Federici, N.

AU - Peric, D.

AU - D’Andrea, N.

AU - Santori, G.

AU - Mojoli, F.

AU - Forfori, F.

AU - Vetrugno, L.

AU - Bove, T.

PY - 2021

Y1 - 2021

N2 - OBJECTIVE: Up to 50% of patients hospitalized for acute heart failure (AHF) show resistance to diuretics. This condition contributes to a prolonged hospital length of stay and a higher risk of death. This review aimed to investigate whether a diuretic therapeutic approach more effective than furosemide alone exists for patients with diuretic-resistant AHF. MATERIALS AND METHODS: We identified all randomized controlled trials (RCTs) evaluating diuretic therapy in patients with diuretic-resistant AHF. We searched Pubmed, BioMed Central, and Cochrane CENTRAL databases. RESULTS: Six RCTs were identified, involving a total of 845 patients. The P-score ranges from 0.6663 for furosemide to 0.2294 for the tolvaptan-furosemide. We found no significant differences in efficacy for any drug comparison. CONCLUSIONS: None of the diuretics considered in RCTs performed to date (tolvaptan, metolazone, hydrochlorothiazide, indapamide) appear to be more effective than furosemide therapy alone for the treatment of patients with diuretic-resistant AHF.

AB - OBJECTIVE: Up to 50% of patients hospitalized for acute heart failure (AHF) show resistance to diuretics. This condition contributes to a prolonged hospital length of stay and a higher risk of death. This review aimed to investigate whether a diuretic therapeutic approach more effective than furosemide alone exists for patients with diuretic-resistant AHF. MATERIALS AND METHODS: We identified all randomized controlled trials (RCTs) evaluating diuretic therapy in patients with diuretic-resistant AHF. We searched Pubmed, BioMed Central, and Cochrane CENTRAL databases. RESULTS: Six RCTs were identified, involving a total of 845 patients. The P-score ranges from 0.6663 for furosemide to 0.2294 for the tolvaptan-furosemide. We found no significant differences in efficacy for any drug comparison. CONCLUSIONS: None of the diuretics considered in RCTs performed to date (tolvaptan, metolazone, hydrochlorothiazide, indapamide) appear to be more effective than furosemide therapy alone for the treatment of patients with diuretic-resistant AHF.

KW - Acute heart failure

KW - Diuretic resistance

KW - Efficacy

KW - Furosemide

KW - Network meta-analysis

KW - Tolvaptan

UR - http://www.scopus.com/inward/record.url?scp=85104432793&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85104432793&partnerID=8YFLogxK

U2 - 10.26355/eurrev_202104_25550

DO - 10.26355/eurrev_202104_25550

M3 - Review article

AN - SCOPUS:85104432793

SN - 1128-3602

VL - 25

SP - 2971

EP - 2980

JO - European Review for Medical and Pharmacological Sciences

JF - European Review for Medical and Pharmacological Sciences

IS - 7

ER -

Comparison of diuretic strategies in diuretic-resistant acute heart failure: A systematic review and network meta-analysis

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this