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首页> 外文期刊>The American Journal of Cardiology >Meta-analysis of cardiovascular outcomes with dronedarone in patients with atrial fibrillation or heart failure
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Meta-analysis of cardiovascular outcomes with dronedarone in patients with atrial fibrillation or heart failure

机译：心房颤动或心脏衰竭患者Dronedarone的心血管结果的Meta分析

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Dronedarone is a benzofuran derivative approved by the Food and Drug Administration to decrease the risk of cardiovascular hospitalization in patients with paroxysmal or persistent atrial fibrillation (AF) and associated cardiovascular risk factors who are in sinus rhythm or will undergo cardioversion. There has been recent evidence to suggest that dronedarone may not have a favorable safety profile. We decided to evaluate all available evidence on the cardiovascular safety of this drug. A systematic search was made of the PubMed, CENTRAL, and EMBASE databases for randomized controlled trials from 1966 through 2011 comparing dronedarone to comparators in AF/heart failure. Intervention was dronedarone for AF for some studies and heart failure for others. Comparators included standard medical therapy and/or placebo and amiodarone for 1 study. Outcomes assessed were all-cause mortality, cardiovascular mortality, ventricular arrhythmias, embolic events, acute coronary syndrome, heart failure exacerbations, and hospitalization rates in the intervention versus comparator group at the end of <3 months of follow up with abstraction of data by 1 author. Seven randomized controlled trials were included in our analysis. Dronedarone use was associated with a trend toward worse all-cause and cardiovascular mortalities and increased heart failure exacerbations. It also showed numerically higher event rates for all other outcome events except acute coronary syndrome. Our pooled analysis showed increased all-cause and cardiovascular mortalities and increased heart failure exacerbations with use of dronedarone across a wide spectrum of populations. In conclusion, we recommend exercising caution using dronedarone, especially in patients with cardiovascular risk factors.
机译：DronedArone是由食品和药物管理局批准的苯并呋喃衍生物，以减少患有阵发性或持续的心房颤动（AF）和相关心血管危险因素的心血管住院风险，以及在鼻窦节律或将经过心脏致致的心血管危险因素。最近有证据表明DronedArone可能没有有利的安全概况。我们决定评估所有可用证据表明这种药物的心血管安全。系统搜索是由1966年至2011年的随机对照试验的PubMed，Central和Embase数据库，将DronedArone与AF /心力衰竭的比较器进行比较。干预是针对他人的一些研究和心力衰竭的AF Dronedarone。比较器包括标准的医疗疗法和/或安慰剂和胺碘酮，用于1项研究。评估的结果是全导致死亡率，心血管死亡率，室性心律失常，栓塞事件，急性冠状动脉综合征，心力衰竭加剧和治疗率在<3个月后的<3个月后的比较子组合于1作者。我们的分析中包含七项随机对照试验。 DronedArone使用与较差的全因和心血管成年人的趋势有关，并且心力衰竭加剧。除急性冠状动脉综合征外，还显示出除急性冠状动脉综合征外的所有其他结果活动的数量更高的事件率。我们的汇集分析显示出全部原因和心血管衰竭的增加，并且在广泛的种群中使用DronedArone增加了心力衰竭。总之，我们建议使用DronedArone进行谨慎，特别是在心血管危险因素患者中。

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