Meta analysis of the clinical efficacy of levosimontan in combination with tovaptan in patients with acute heart failure
Objective To evaluate the clinical efficacy of levosimontan in combination with tovaptan in patients with acute heart failure.Methods China Journal Full-Text Database,Chinese science and technology periodical database,Wanfang database,PubMed,Cochrane Library for randomized controlled trials in patients with Acute Heart Failure treated with levosimendan combined with tolvaptan were searched from the establishment of each database to January,10,2024.The literature quality was evaluated by the Cochrane risk bias assessment tool,and the literatures of Meta-analysis were used by RevMan 5.4 software.Results A total of 15 literatures were included,involving 1 257 patients.The result of Meta-analysis showed that levosimendan combined with tolvaptan could significantly improve the the clinical efficacy[relative risk(RR)=1.25,95%CI(1.18,1.33),P<0.001],ejection fraction]standardized mean differ-ence(SMD)=1.41,95%CI(1.28,1.53),P<0.001],24 h urine volume[SMD=3.89,95%CI(3.12,4.65),P<0.001]、heart rate[mean difference(MD)=-16.35,95%CI(-18.30,-14.40),P<0.001]of patients with severe acute heart fail-ure.No difference between the incidence of adverse reactions compared with control group,including dry mouth[RR=1.56,95%CI(0.61,3.99),P=0.35],nausea[RR=0.45,95%CI(0.10,1.97),P=0.29],headache[RR=1.33,95%CI(0.30,5.88),P=0.70].Conclusion The combination of levosimendan and tolvaptan can significantly reduce the clinical symptoms of patients,increase ejection fraction and 24 h urine volume,reduce heart rate,improve Heart function,re-duce case fatality rate,and is safe and reliable.
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