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What We Learned With Recent Network Meta-analyses on Acute Heart Failure Care

  • Cardiovascular Care (L Roever, Section Editor)
  • Published:
Current Emergency and Hospital Medicine Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Acute heart failure remains a common and ominous clinical condition. Several interventions are currently available, with ensuing difficulties in prioritizing and formalizing decision-making. Network meta-analysis appears particularly promising to summarize the evidence base on competing interventions. We thus aimed to review, appraise, and summarize recent network meta-analyses on acute heart failure care.

Recent Findings

We searched for recent network meta-analyses on acute heart failure care, retrieving five reviews, encompassing a total of 101 randomized trials and 19,085 patients. Three reviews focused on severe sepsis or septic shock, one review on shock-refractory ventricular arrhythmias, and one review on high-risk percutaneous coronary intervention. Quality of reporting and internal validity of the reviews was moderate, with common shortcomings on protocol registration and confounding appraisal. No single intervention or combo proved clearly superior for severe sepsis or septic shock, lidocaine appeared as the best strategy for shock-refractory ventricular arrhythmias, and medical therapy appeared most favorable for high-risk percutaneous coronary intervention.

Summary

Recent network meta-analyses on acute heart failure begin to offer guidance for comparative effectiveness and improved clinical decision-making. Further synthesizing efforts are however needed to provide a more comprehensive and updated synthesis of the multitude of clinical alternatives for physicians caring for patients with acute heart failure.

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Authors and Affiliations

  1. Division of Cardiology, San Giovanni-Addolorata Hospital, Rome, Italy

    Laura Gatto

  2. Department of Clinical Research, Federal University of Uberlandia, Uberlandia, Brazil

    Leonardo Roever

  3. Division of Cardiology, Santa Maria Goretti Hospital, Latina, Italy

    Francesco Versaci

  4. Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100, Latina, Italy

    Mariangela Peruzzi, Sebastiano Sciarretta, Antonino G. M. Marullo, Giacomo Frati & Giuseppe Biondi-Zoccai

  5. Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy

    Sebastiano Sciarretta, Giacomo Frati & Giuseppe Biondi-Zoccai

Authors
  1. Laura Gatto
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  2. Leonardo Roever
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  3. Francesco Versaci
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  4. Mariangela Peruzzi
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  5. Sebastiano Sciarretta
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  6. Antonino G. M. Marullo
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  7. Giacomo Frati
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  8. Giuseppe Biondi-Zoccai
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Corresponding author

Correspondence to Giuseppe Biondi-Zoccai.

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Conflicts of Interest

Prof. Biondi-Zoccai has consulted for Abbott Vascular and Bayer.

Additional information

This article is part of the Topical Collection on Cardiovascular Care

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Gatto, L., Roever, L., Versaci, F. et al. What We Learned With Recent Network Meta-analyses on Acute Heart Failure Care. Curr Emerg Hosp Med Rep 6, 49–53 (2018). https://doi.org/10.1007/s40138-018-0155-8

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  • DOI: https://doi.org/10.1007/s40138-018-0155-8

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