A meta-analysis of low-dose dopamine in heart failure

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• 作者：Fuwei Xing¹ ; Xiaoliang Hu¹ ; Jingzhou Jiang¹ ; Yuedong Ma ; ¹ ; ^{xingfuwei1992@sina.com" class="auth_mail" title="E-mail the corresponding author} ; Anli Tang ; ¹ ; ^{15626428670@163.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Heart failure ; Low-dose ; Dopamine ; Renal function ; Meta-analysis ; Clinical trials
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：1 November 2016
• 年：2016
• 卷：222
• 期：Complete
• 页码：1003-1011
• 全文大小：1823 K

文摘

Heart failure (HF) is a major health problem worldwide with no proven therapy. Low-dose dopamine (LDD) has been applied to patients with HF to enhance diuresis and preserve renal function since the last century. However, the efficacy of LDD in HF has been questioned by several studies recently. The purpose of this meta-analysis is to appraise the effects of the LDD to HF.

Methods

Relative trials were identified in the PubMed, The Web of Science, OVID EBM Reviews and Cochrane databases, and the relevant papers were examined. Pooled mean difference (MD) and 95% confidence interval (95% CI) were estimated by random effects models. The primary endpoints in our meta-analysis were renal function, determined by blood urea, creatinine levels, eGFR and urine output. Secondary endpoints were rates of all-cause mortality and readmission after treatment.

Results

Six randomized controlled trials (RCTs) and one retrospective study involving 587 patients were included in this analysis. LDD enhanced eGFR (MD, 7.44; 95% CI, 1.92–12.95; P = 0.008), urine output (SMD, 0.58; 95% CI, 0.15–1.01; P = 0.008) and decrease creatinine levels (MD, − 0.36; 95% CI, − 0.64/− 0.08; P = 0.004), blood urea (MD, − 6.97; 95% CI, − 13.12/− 0.81; P = 0.03). No statistically significant differences in the rates of mortality (RR, 0.86; 95% CI, 0.62–1.20, P = 0.37) and readmission (RR: 0.86; 95% CI 0.47–1.56, P = 0.62) were noted.

Conclusions

LDD indeed brought benefits in terms of promoting diuresis and preserving renal function for HF patients. It did not demonstrate statistical significance in rates of readmission nor mortality. The efficacy of LDD to HF patients should be confirmed by further large, high quality clinical trials.