SynthesisThe American journal of emergency medicine2015
Lack of evidence for intravenous vasodilators in ED patients with acute heart failure: a systematic review.
Synthesis in The American journal of emergency medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Ultrafiltration for acute heart failure.The Cochrane database of systematic reviews · 2022Pooled it
- Urapidil, compared to nitroglycerin, has better clinical safety in the treatment of hypertensive patients with acute heart failure: a meta-analysis.Drug design, development and therapy · 2019Pooled it
- Clinical efficacy and safety of nuanxin capsule for chronic heart failure: A systematic review and meta-analysis.Medicine · 2018Pooled it
- Rate pressure product and the components of heart rate and systolic blood pressure in hospitalized heart failure patients with preserved ejection fraction: Insights from ASCEND-HF.Clinical cardiology · 2018Trial
- Efficacy and Safety of Intravenous Urapidil for Older Hypertensive Patients with Acute Heart Failure: A Multicenter Randomized Controlled Trial.Yonsei medical journal · 2017Trial
- Vasodilators for acute heart failure-A protocol for a systematic review of randomized clinical trials with meta-analysis and Trial Sequential Analysis.Acta anaesthesiologica Scandinavica · 2022Article
- Nitroglycerin Use in the Emergency Department: Current Perspectives.Open access emergency medicine : OAEM · 2022Review
- Ultra-high dose intravenous nitroglycerin in an ESRD patient with acutely decompensated heart failure.Journal of the American College of Emergency Physicians open · 2021Article
- Blood Pressure Reduction in Hypertensive Acute Heart Failure.Current hypertension reports · 2021Review
- Vasodilator Therapies in the Treatment of Acute Heart Failure.Current heart failure reports · 2019Review
- Early Treatment in Emergency Department Patients with Acute Heart Failure: Does Time Matter?Current heart failure reports · 2019Review
- YiQiFuMai injection for chronic heart failure: Protocol for a systematic review and meta-analysis.Medicine · 2018Article
- Intravenous enalaprilat for treatment of acute hypertensive heart failure in the emergency department.International journal of emergency medicine · 2016Article
- Therapies to Reduce Blood Pressure Acutely.Current hypertension reports · 2016Review
- Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
There are nearly 700,000 annual US emergency department (ED) visits for acute heart failure (AHF). Although blood pressure is elevated on most of these visits, acute therapy remains focused on preload and not afterload reduction. Data from recent prospective studies suggest that patients with AHF with concomitant acute hypertension benefit from intravenous (IV) vasodilators. To better understand the use of vasodilators for such patients, we conducted a systematic review of (1) currently available intravenous vasodilators for ED patients with AHF, or (2) intravenous vasodilators that are not yet available, but have completed phase III clinical trials in AHF, and may be available for ED use in the future. We used multiterm search queries to retrieve research involving nitroglycerin, nitroprusside, enalaprilat, hydralazine, relaxin, and nesiritide. A total of 2001 unique citations were identified from 3 databases: PubMed, EMBASE, and CINAHL. Of these, 1966 were excluded on the basis of established review criteria, leaving 35 published articles for inclusion. Our primary finding was that intravenous nitrovasodilators, when used in the treatment of AHF in ED and ED-like settings, do improve short-term symptoms and appear safe to administer. There are no data suggesting that they impact mortality. Other commonly used vasodilators such as hydralazine and enalaprilat have very little published data about their safety and efficacy. Of note, few studies enrolled patients early in their course of treatment. Thus, to assess the specific impact of vasodilator therapy on both short- and long-term outcomes, future research efforts should focus on patient recruitment in the ED setting.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.