Long-term beta blockers for stable angina: systematic review and meta-analysis

Shu, De Fen; Dong, Bi Rong; Lin, Xiu Fang; Wu, Tai Xiang; Liu, Guan Jian

doi:10.1177/1741826711409325

Cited by 49 publications

(15 citation statements)

References 27 publications

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“…Therefore, improvement in quality of life is an important goal and a measure of therapeutic success in these patients. Despite this, there are few studies regarding improvements in quality of life on antianginal therapy (including beta-blocker) and the results are generally inconsistent [25][26][27][28].…”

Section: Introductionmentioning

confidence: 94%

Ivabradine in combination with beta-blocker improves symptoms and quality of life in patients with stable angina pectoris: results from the ADDITIONS study

et al. 2012

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Section: Introductionmentioning

confidence: 94%

Ivabradine in combination with beta-blocker improves symptoms and quality of life in patients with stable angina pectoris: results from the ADDITIONS study

et al. 2012

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“…Studies by Dargie et al and Rehnqvist et al demonstrated no mortality benefit with either BB, CA or the combination of both [39, 40]. Furthermore, in a meta-analysis by Shu et al, BBs did not reduce the risk of death or acute myocardial infarction in patients with stable ischemic heart disease [41]. A large longitudinal, observational analysis of 44,708 patients divided into three cohorts, those with known prior myocardial infarction, those with known coronary artery disease without myocardial infarction, and those with coronary artery disease risk factors only, found that the use of BBs was not associated with a lower risk of cardiovascular death, nonfatal MI, or nonfatal stroke.…”

Section: Management Of Anginamentioning

confidence: 99%

Advancements in pharmacotherapy for angina

Jain

Elgendy

Al‐Ani

et al. 2017

Expert Opinion on Pharmacotherapy

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Introduction Angina pectoris is the most prevalent symptomatic manifestation of ischemic heart disease, frequently leads to a poor quality of life, and is a major cause of medical resource consumption. Since the early descriptions of nitrite and nitrate in the 19th century, there has been considerable advancement in the pharmacologic management of angina. Areas covered Management of chronic angina is often challenging for clinicians. Despite introduction of several pharmacological agents in last few decades, a significant proportion of patients continue to experience symptoms (i.e., refractory angina) with subsequent disability. For the purpose of this review, we searched PubMed and Cochrane databases from inception to August 2016 for the most clinically relevant publications that guide current practice in angina therapy and its development. In this article, we briefly review the pathophysiology of angina and mechanism-based classification of current therapy. This is followed by evidence-based insight into the traditional and novel pharmacotherapeutic agents, highlighting their clinical usefulness. Expert opinion Considering the wide array of available therapies with different mechanism efficacy and limiting factors, a personalized approach is essential, particularly for patients with refractory angina. Ongoing research with novel pharmacologic modalities is likely to provide new options for management of angina.

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“…A systematic review and meta-analysis of randomised trials with nitrates for stable angina pectoris suggested that long-term administration of nitrates is beneficial for angina prophylaxis and improves exercise performance but might be ineffective for improving quality of life 6. Another systematic review and meta-analysis of randomised controlled trials (RCTs) on long-term BBs for stable angina pectoris suggested that BBs may decrease the rates of death and unstable angina when compared with no treatment but are no more effective than other antianginal agents on prophylaxis of myocardial ischaemia 7. Meta-analysis of randomised trials of BBs for stable angina suggested that BBs do not have statistically signiﬁcant impact on mortality versus placebo or versus other active comparators 8.…”

Section: Introductionmentioning

confidence: 99%

Drug efficacy in treating stable angina pectoris: a protocol for network meta-analysis of randomised controlled trials

Jia

Leung²

2014

BMJ Open

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IntroductionThere were 11 pairwise meta-analysis on the efficacy of β-blockers (including atenolol, propranolol, bisoprolol, metoprolol and nadolol), calcium channel blockers (including amlodipine, diltiazem, felodipine, nifedipine and verapamil), and nitrates (including isosorbide dinitrate, isosorbide mononitrate and nitroglycerin) in treating stable angina pectoris. No network meta-analytic study has been published to evaluate the efficacies of these antianginal drugs. Current clinical guidelines (eg, National Institute of Health and Care Excellence (NICE) clinical guideline 126) are only based on the findings of limited clinical trials and pairwise meta-analysis. This study aims to fill this gap of research by conducting a Bayesian network meta-analysis to compare all these antianginal drugs.Methods and analysesRandomised controlled trials (RCT) on the drug therapy of stable angina pectoris with multiple outcome measures, selected from symptomatic relief, ECG tests, exercise tests, heart rates and blood pressures, etc, will be included. Overall effect sizes will be represented as mean differences with 95% credible intervals (CrI) for continuous outcome data and as ORs with 95% CrI for dichotomous outcome data. Bayesian network meta-analysis by WinBUGS will be conducted to compare the efficacies of these drugs. Sensitivity analysis on the quality of RCTs and subgroup analysis on the category of included drugs will be performed.Ethics and disseminationEthical approval is not required because this study includes no confidential personal data and interventions on the patients. Network meta-analysis is based on the RCT reports of eligible drugs in treating stable angina pectoris. The results of this study will be disseminated by an open access and peer-reviewed publication.Trial registration numberPROSPERO CRD42014007113.

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Long-term beta blockers for stable angina: systematic review and meta-analysis

Abstract: Beta blockers may decrease the death and unstable angina when compared with no treatment, but no more effective than other anti-anginal agents on prophylaxis of myocardial ischaemia in stable angina patients.

Cited by 49 publications

References 27 publications

Ivabradine in combination with beta-blocker improves symptoms and quality of life in patients with stable angina pectoris: results from the ADDITIONS study

Ivabradine in combination with beta-blocker improves symptoms and quality of life in patients with stable angina pectoris: results from the ADDITIONS study

Advancements in pharmacotherapy for angina

Drug efficacy in treating stable angina pectoris: a protocol for network meta-analysis of randomised controlled trials

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