ABSTRACT
INTRODUCTION: Even with the adequate use of diuretics and vasodilators, volume overload and congestion are the major causes of morbidity and mortality in patients hospitalized with acute heart failure (HF). We aim to evaluate the additive effect of tolvaptan on efficacy parameters as well as outcomes in hospitalized patients with HF. METHODS: We searched PubMed, EMBASE, Cochrane library, and Web of Science databases for randomized controlled trials that studied the effects of tolvaptan versus placebo in hospitalized patients with HF. Studies were included if they had any of the following endpoints: mortality, re-hospitalization, and in-hospital parameters like dyspnea relief, change in weight, sodium, and creatinine. RESULTS: The meta-analysis analyzed data from 14 studies involving 5945 patients. The follow up duration ranged from 30 days to 2 years. Between tolvaptan and placebo groups, there was no difference in mortality and rehospitalization. HF patients had a better dyspnea relief score (Likert score) in tolvaptan group and mean reduction in weight in the first 48 h (short-term). However, at 7 days (medium-term) the mean difference in weight was not significant. Serum sodium increased significantly in tolvaptan group. There was no difference in creatinine among the two groups. CONCLUSIONS: Our meta-analysis shows that tolvaptan helps in short-term symptomatic dyspnea relief and weight reduction, but there are no long term benefits including reduction in mortality and rehospitalization.
Subject(s)
Antidiuretic Hormone Receptor Antagonists , Heart Failure , Tolvaptan , Antidiuretic Hormone Receptor Antagonists/therapeutic use , Benzazepines/therapeutic use , Hospitalization , Humans , Randomized Controlled Trials as Topic , Tolvaptan/therapeutic useABSTRACT
Building a cardiology career leaves little room for creative pursuits. Creative inclinations wither away as methodical approach presides. Several talented cardiologists demonstrate unique harmony between their right and left brains. Their love for art and imagination rekindles our creative spirit. Creative endeavors promote resilience and wellness, making us better professionals.
