Efficacy and safety of low‐dose sacubitril/valsartan in heart failure patients: A systematic review and meta‐analysis

Abstract

Background: Controversy has persisted over the clinical benefits of low-dose sacubitril/valsartan in patients with heart failure (HF).Hypothesis: Low-dose sacubitril/valsartan might also be effective and safe in HF patients.Methods: Electronic databases including PubMed, Ovid, and Cochrane Library were systematically retrieved from inception to August 5, 2021. Review manager 5.4 and Stata 15.1 were employed in this systematic review and meta-analysis. Key efficacy outcomes of interest included HF hospitalization, all-cause mortality, left ventricular ejection fraction (LVEF), N-terminal pro-B-type natriuretic peptide (NT-proBNP), together with New York Heart Association (NYHA) functional class. The safety outcome was systolic blood pressure (SBP). The grading of recommendations assessment, development, and evaluation approach was conducted to evaluate the quality of evidence for each outcome.Results: A total of 1269 studies were screened and 9 real-world studies met the inclusion criteria were included in the meta-analysis, with 1697 participants. Compared with low-dose sacubitril/valsartan, high-dose sacubitril/valsartan significantly reduced the risk of HF hospitalization (odds ratio [OR]: 0.4, 95% confidence interval [CI]: 0.27-0.61, p < .0001) and the risk of all-cause mortality (OR: 0.23, 95% CI: 0.11-0.47, p < .0001). However, there were no appreciable differences in improvements of NYHA

Growth hormone reduces aneuploidy and improves oocytes quality by JAK2-ERK1/2 pathway in aging mice

“…In assisted reproductive technology (ART), GH is used as an adjunct to ovarian stimulation in patients with a poor ovarian response (POR), although its role is still controversial. Several studies have reported that GH improves ART outcomes in POR patients (11,12), consistent with our recent reports that GH supplementation increases the clinical pregnancy and live birth rates (13,14). In animal models, GH supplementation has recently been show to improve the oocyte quality by enhancing mitochondrial function (15,16).…”