Heart failure & cardiomyopathiesMeta-analysis
Minimization or Withdrawal of Oral Pharmacotherapy in Chronic Heart Failure Patients with Improved Myocardial Function: A Systematic Review
- Systematic review
Search of MEDLINE, Embase and Cochrane CENTRAL from inception to 18 October 2024
Authors' conclusion
The existing evidence on minimizing or withdrawing oral pharmacotherapy in chronic HF patients with improved myocardial function remains very limited and heterogeneous, supporting only loop diuretic withdrawal and possibly carvedilol monotherapy, but not the minimization or withdrawal of renin-angiotensin system inhibitors, MRA, or the combination of HF medications.
Study context
- Population
- Chronic heart failure (HF) patients with improved EF or stable NYHA status
- Participants
- 552 patients · 7 studies
- Comparison
- Minimization or withdrawal of oral pharmacotherapy vs continued therapy
Pooled result
As reported in the abstract
Relapse after multiple drug withdrawal, recovered dilated cardiomyopathy (1 randomized controlled trial (RCT), n = 51)
65%
Cardiac dimensional deterioration after multiple drug withdrawal, post-CRT with normalized EF (1 RCT, n = 80)
7.5%
Drug re-initiation due to cardiac comorbidities (same RCT, n = 80)
28%
Original publication
Summarised from the published abstract; every number is checked against it