Meglumine adenosine cyclophosphate combining angiotensin converting enzyme inhibitor for treating chronic heart failure：a systematic review
TANG Li-xin
TANG Wei
Abstract：Objective To systemically review the safety and effectiveness of meglumine adenosine cyclophosphate (MAC) combining angiotensin converting enzyme inhibitor (ACEI) in treatment of chronic heart failure (CHF).Methods The databases of Cochrane Libratory (from 1995 to Aug. 20, 2014), PubMed (from 1966 to Aug. 20, 2014), EMBase (from 1974 to Aug. 20, 2014), VIP Database (from 1989 to Aug. 20, 2014), CBM (from 1978 to Aug. 20, 2014) and CNKI (from 1994 to Aug. 20, 2014) were retrieved with computer, and relevant journals and conference proceedings were also manually retrieved. The randomized controlled trials (RCT) about treatment of CHF with MAC combining ACEI were collected and compared. The data were given a Meta-analysis by using RevMan5.0 software.Results There were totally 24 RCT included involving 2042 cases, and 1036 in MAC+ACEI+routine therapy group and 1006 in ACEI+routine therapy group. The results of Meta-analysis showed that MAC+ACEI+routine therapy group was superior to ACEI+routine therapy group in decreasing BNP [SMD=-0.90, 95%CI (-1.36, -0.44);P=0.0001], reducing LVESd [SMD=-0.39, 95%CI (-0.70, -0.08);P=0.01], increasing SV [SMD=0.86, 95%CI (0.45, 1.26);P<0.001], improving 6MWT [SMD=0.84, 95%CI (0.61, 1.08);P<0.001], increasing LVEF [SMD=0.78, 95%CI (0.50, 1.06);P<0.001], improving heart function effectively [RR=1.38, 95%CI (1.25, 1.54);P<0.001] and improving heart function invalidly [RR=0.38, 95%CI (0.30, 0.48);P<0.001]. There was no statistical difference in decreasing heart rate [SMD=-0.06, 95%CI (-1.62, 0.29);P=0.17], improving CO [SMD=0.50, 95%CI (-0.03, 1.03); P=0.07], increasing CI [SMD=0.78, 95%CI (-0.19, 1.75);P=0.11], reducing LVEDd [SMD=-0.15, 95%CI (-0.35, 0.05);P=0.14], improving heart function effectively [RR=0.99, 95%CI (0.89, 1.10);P=0.79] and reducing adverse reactions [RR=0.88, 95%CI (0.33, 2.34);P=0.79] between 2 groups.Conclusion The present clinical evidence indicates that MAC combining ACEI can effectively relieve symptoms in patients with CHF and does not increase adverse reactions. Because of selective and detective bias, the proof intensity of results is influenced. More RCT with higher quality are required for further providing high-quality evidence.
Keywords：Meglumine adenosine cyclophosphateAngiotensin converting enzyme inhibitorChronic heart failureSystematic reviewMeta-analysisRandomized controlled trial
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 176-183 )