Affiliation:
1. Health Technology Assessment Area‐AETSA Andalusian Public Foundation Progress and Health‐FPS Seville Spain
2. Heart Failure and Cardiomyopathy Unit Cardiology Service Ramón y Cajal Hospital Madrid Spain
3. Epidemiologist at Seville Primary Care Health District Seville Spain
Abstract
AbstractBaroreflex activation therapy (BAT) is a possible adjuvant treatment for patients with heart failure with reduced ejection fraction (HFrEF) who remain symptomatic despite optimal medical therapy and may be an alternative therapy in patients with contraindications or drug intolerance. Our aim was to evaluate the efficacy and safety of BAT in patients with HFrEF. The protocol for this study was registered with PROSPERO (CRD42022349175). Searches were conducted using MEDLINE, preMedLine (via PubMed), EMBASE, Cochrane Library, Web of Science, Trip Medical Database, WHO International Clinical Trials Registry, and ClinicalTrials.gov. We included randomized controlled trials that compared the effects of BAT with pharmacological treatment. We assessed the risk of bias of each study using the Cochrane RoB2 tool and the certainty of the results using the GRADE approach. We performed a meta‐analysis of treatment effects using a fixed‐effects or random‐effects model, depending on the heterogeneity observed. Two studies were included in the meta‐analysis (HOPE4HF and BeAT‐HF). The results showed that BAT led to statistically significant improvements in New York Heart Association functional class (relative risk 2.13; 95% confidence interval [CI, 1.65 to 2.76]), quality of life (difference in means −16.97; 95% CI [−21.87 to −12.07]), 6 min walk test (difference in means 56.54; 95% CI [55.67 to 57.41]) and N‐terminal probrain natriuretic peptide (difference in means −120.02; 95% CI [−193.58 to −46.45]). The system‐ and procedure‐related complication event‐free rate varied from 85.9% to 97%. The results show that BAT is safe and improves functional class, quality of life and congestion in selected patients with HFrEF. Further studies and long‐term follow‐up are needed to assess efficacy in reducing cardiovascular events and mortality.
Funder
Ministerio de Sanidad, Política Social e Igualdad
Subject
Cardiology and Cardiovascular Medicine
Cited by
1 articles.
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