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, 8 (1), 251

The Effects of Adding Angiotensin Receptor Neprilysin Inhibitors to Usual Care in Patients With Heart Failure: A Protocol for a Systematic Review of Randomised Clinical Trials With Meta-Analysis and Trial Sequential Analysis

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The Effects of Adding Angiotensin Receptor Neprilysin Inhibitors to Usual Care in Patients With Heart Failure: A Protocol for a Systematic Review of Randomised Clinical Trials With Meta-Analysis and Trial Sequential Analysis

Emil Eik Nielsen et al. Syst Rev.

Abstract

Background: Heart failure is a highly prevalent disease with a global prevalence of 37 million, and the prevalence is increasing. Patients with heart failure are at an increased risk of death and morbidity. Traditionally, patients with heart failure have been treated with a beta-blocker in addition to an inhibitor of the renin-angiotensin-aldosterone system. However, new drugs are currently being added to the recommended guideline therapy. The latest drug to be added combines inhibition of the renin-angiotensin-aldosterone system pathway with inhibiting the neprilysin enzyme and is therefore classified as an ARNI. Our objective is to identify the beneficial and harmful effects of ARNIs in the treatment of patient with heart failure.

Methods: This protocol for a systematic review was undertaken using the recommendations of the Cochrane, the Preferred Report Items of Systematic reviews with Meta-Analysis Protocols, and the eight-step assessment procedure suggested by Jakobsen and colleagues. We plan to include all relevant randomised clinical trials assessing the use of ARNIs in the treatment of patients with heart failure. We will search the Cochrane Central Register of Controlled Trials (CENTRAL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), Latin American and Caribbean Health Sciences Literature (LILACS), Science Citation Index Expanded on Web of Science, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Science Journal Database (VIP), and BIOSIS to identify relevant trials. We will also search for grey literature and unpublished trials. Extracted data will be analysed using Review Manager 5, STATA 5, and Trial Sequential Analysis. Our primary outcomes will be all-cause mortality and serious adverse events. We will create a 'Summary of Findings' table in which we will present our primary and secondary outcomes, and we will assess the quality of evidence using the GRADE assessment.

Discussion: The present systematic review will have the potential to aid clinicians in decision-making and thereby, benefit patients with heart failure.

Systematic review registration: PROSPERO CRD42019129336.

Keywords: ARNI; Angiotensin receptor neprilysin inhibitors; Heart failure; Meta-analysis trial sequential analysis; Systematic review.

Conflict of interest statement

The authors declare that they have no competing interests.

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References

    1. Bui AL, Horwich TB, Fonarow GC. Epidemiology and risk profile of heart failure. Nat Rev Cardiol. 2011;8(1):30–41. doi: 10.1038/nrcardio.2010.165. - DOI - PMC - PubMed
    1. Ziaeian B, Fonarow GC. Epidemiology and aetiology of heart failure. Nat Rev Cardiol. 2016;13(6):368–378. doi: 10.1038/nrcardio.2016.25. - DOI - PMC - PubMed
    1. Writing Committee M, Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Jr, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;128(16):e240–e327. - PubMed
    1. Vos T, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1211–1259. doi: 10.1016/S0140-6736(17)32154-2. - DOI - PMC - PubMed
    1. Sakata Y, Shimokawa H. Epidemiology of heart failure in Asia. Circ J. 2013;77(9):2209–2217. doi: 10.1253/circj.CJ-13-0971. - DOI - PubMed

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