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Systematic Reviews
Published in: Systematic Reviews 1/2019

Open Access 01-12-2019 | Heart Failure | Protocol

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

Authors: Emil Eik Nielsen, Joshua Feinberg, Ilan Raymond, Michael Hecht Olsen, Frank Victor Steensgaard-Hansen, Janus Christian Jakobsen

Published in: Systematic Reviews | Issue 1/2019

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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 We will also search for grey literature and unpublished trials.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

Appendix
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Metadata
Title
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
Authors
Emil Eik Nielsen
Joshua Feinberg
Ilan Raymond
Michael Hecht Olsen
Frank Victor Steensgaard-Hansen
Janus Christian Jakobsen
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Heart Failure
Published in
Systematic Reviews / Issue 1/2019
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-019-1173-7

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