ObjectiveTo systematically review the efficacy and safety of sacubitri valsartan in the treatment of hypertension. MethodsPubMed, ClinicalTrials.gov, CNKI, WanFang Data and CBM databases were electronically searched to collect randomized controlled trials (RCTs) of sacubitril valsartan in the treatment of hypertension from inception to August 31, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 and Stata 13.0 software. ResultsA total of 11 RCTs involving 3 564 patients were included. Meta-analysis showed that compared with control group, sitting systolic blood pressure (MD=?6.85, 95%CI ?9.94 to ?3.76, P<0.01) and sitting diastolic blood pressure (MD=?3.70, 95%CI ?5.61 to ?1.79, P<0.01) significantly decreased in the experimental group, and the difference was statistically significant. The results of subgroup analysis did not show significant changes. At the same time, the incidence of adverse reactions with sacubitril valsartan was low, and no fatal adverse events were observed. ConclusionCurrent evidence shows that sacubitril valsartan in the treatment of hypertension has definite efficacy and fewer adverse reactions. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To systematically review the impact of cardiac shock waves on coronary artery disease. Methods The PubMed, Cochrane Library, Wed of Science, EMbase, ClinicalTrials.gov, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect randomized controlled trials and cohort studies related to the treatment of coronary artery disease with cardiac shock waves from inception to August 2022. After two evaluators independently screened the literature, extracted data, and evaluated the risk of bias of the included studies, a meta-analysis was conducted by using RevMan 5.4.1 and Stata 15.0 software. Results A total of 11 studies with 519 patients were included. The meta-analysis results revealed that compared with the control group, cardiac shock wave therapy could reduce hospitalization rates (RR=0.38, 95%CI 0.25 to 0.57, P<0.01), increase exercise time (SMD=0.93, 95%CI 0.17 to 1.70, P=0.02), and improve the Canadian Cardiovascular Society (CCS) angina grading (MD=?0.62, 95%CI ?0.73 to ?0.51, P<0.01), the New York Heart Association (NYHA) cardiac function grading (MD=?0.60, 95%CI ?0.85 to ?0.35, P<0.01), left ventricular ejection fraction (MD=4.81,95%CI 3.17 to 6.46, P<0.01), total score of the Seattle angina questionnaire (SAQ) (MD=10.87, 95%CI 4.63 to 17.12, P<0.01), and 6-min walking test (MD=85.06, 95%CI 31.02 to 139.09, P<0.01). Conclusion Cardiac shock wave therapy can improve cardiac function as well as the prognosis and exercise ability. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically evaluate risk prediction models for ventricular arrhythmia (VA) following percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI), aiming to provide references for the development, optimization, and application of the models. MethodsDatabases including CNKI, Wanfang, VIP, Chinese Biomedical Literature Database, PubMed, Embase, and Cochrane Library were searched for studies on VA prediction models after PCI in AMI patients from inception to September 2025. Two researchers independently screened the literature, extracted data, and assessed the quality of included studies using the prediction model risk of bias assessment tool. Meta-analysis of common predictors was performed using Stata 18.0 software, and the area under the curve (AUC) of the models was statistically analyzed using MedCalc software. ResultsA total of 12 studies were included, establishing 12 models involving 3411 patients. The incidence of VA ranged from 11.0% to 50.8%, with an overall incidence of approximately 24.5%. The AUC values of the 12 models ranged from 0.717 to 0.983, indicating good predictive performance. However, the overall risk of bias in the included studies was high. Statistical analysis yielded a pooled AUC of 0.853 [95%CI (0.807, 0.899)]. Meta-analysis results showed that Killip class, left ventricular ejection fraction, thrombolysis in myocardial infarction flow grade, number of diseased coronary vessels, troponin levels, diabetes mellitus, J-wave on electrocardiogram, and serum potassium level were independent predictive factors for VA after PCI in AMI patients (P<0.05). ConclusionThe risk prediction models for VA after PCI in AMI patients demonstrate good overall discrimination. However, existing studies generally suffer from a high risk of bias, and the calibration and external validation of the models are severely insufficient, limiting their direct clinical applicability. Future multicenter, large-sample, prospective studies are needed to optimize study design and reporting processes, aiming to develop and validate more robust prediction models suitable for clinical practice, facilitating early identification and prevention of VA after PCI in AMI patients.
