Evidence map›Paper›PMID 36294308›Full record

ReviewJournal of clinical medicine2022

Post-Implant Phosphodiesterase-5 Inhibitors in Patients with Left Ventricular Assist Device: A Systematic Review and Meta-Analysis.

Andrew Xanthopoulos, Dimitrios E Magouliotis, Konstantinos Tryposkiadis, Prokopis-Andreas Zotos, Kyriakos Spiliopoulos, Thanos Athanasiou, Grigorios Giamouzis, John Skoularigis, Randall C Starling, Filippos Triposkiadis

Abstract readReview
In one paragraph

Review in Journal of clinical medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Andrew XanthopoulosDepartment of Cardiology, University Hospital of Larissa, 411 10 Larissa, Greece.ORCID 0000-0002-9439-3946
Dimitrios E MagouliotisDepartment of Cardiothoracic Surgery, University of Thessaly, Biopolis Campus, 415 00 Larissa, Greece.ORCID 0000-0001-5417-6392
Konstantinos TryposkiadisIndependent Researcher, 156 69 Athens, Greece.
Prokopis-Andreas ZotosDepartment of Cardiothoracic Surgery, University of Thessaly, Biopolis Campus, 415 00 Larissa, Greece.
Kyriakos SpiliopoulosDepartment of Cardiothoracic Surgery, University of Thessaly, Biopolis Campus, 415 00 Larissa, Greece.
Thanos AthanasiouDepartment of Cardiothoracic Surgery, University of Thessaly, Biopolis Campus, 415 00 Larissa, Greece.
Grigorios GiamouzisDepartment of Cardiology, University Hospital of Larissa, 411 10 Larissa, Greece.
John SkoularigisDepartment of Cardiology, University Hospital of Larissa, 411 10 Larissa, Greece.ORCID 0000-0001-7159-2478
Randall C StarlingKaufman Center for Heart Failure Treatment and Recovery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USA.ORCID 0000-0002-1254-4860
Filippos TriposkiadisDepartment of Cardiology, University Hospital of Larissa, 411 10 Larissa, Greece.ORCID 0000-0001-6433-4016

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Despite the improvement in left ventricular assist device (LVAD) technology and the advent of third-generation LVADs, hemocompatibility-related events remain a significant issue. Therefore, new pharmacological treatments are necessary to optimize patient management and to further reduce hemocompatibility-related events. The purpose of the present systematic review and meta-analysis was to summarize the existing data regarding the safety and efficacy of post-implant phosphodiesterase-5 inhibitors (PDE-5i) on hemocompatibility-related events. Methods: Among the 258 articles in Pubmed, Scopus, and CENTRAL that were retrieved (1990−2022), 15 studies were included in the qualitative synthesis, and 9 studies were included in the quantitative synthesis. The fixed-effects model was used because it is statistically sound for combining a very small number of studies. The primary endpoint of the study was all-cause mortality, whereas the secondary endpoints were ischemic stroke, pump thrombosis, and gastrointestinal bleeding. Results: Mortality was significantly lower in the PDE-5i group vs. the control group (OR: 0.92 [95% CI: 0.85, 0.98]; p = 0.02). The secondary endpoints ischemic stroke (OR: 0.87 [95% CI: 0.78, 0.98]; p = 0.02) and pump thrombosis (OR: 0.90 [95% CI: 0.82, 0.99]; p = 0.04) were also lower in the PDE-5i group. The incidence of gastrointestinal bleeding was significantly higher in patients with LVAD receiving PDE-5i (OR: 1.26 [95% CI: 1.11, 1.44]; p < 0.01). In the overall analysis, the heterogeneity of outcomes was low, except for pump thrombosis. Conclusions: The use of PDE-5i post-implant was associated with lower mortality and thrombotic events but with a higher risk of gastrointestinal bleeding.

Indexed as

bleedinghemocompatibilityleft ventricular assist devicesmeta-analysismortalityphosphodiesterase-5 inhibitorsthrombosis

Identifiers

PMID36294308
PMCPMC9604415

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Registered trials

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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.