What question did this study set out to answer?

This research investigates the efficacy and safety of mirabegron, a beta 3 agonist, in patients with heart failure compared to a placebo.

January 10, 2026

Is Mirabegron-the novel beta 3 agonist-effective in patients with heart failure? A systematic review and meta-analysis of efficacy and safety

Key Result

Mirabegron significantly improved cardiac index by 0.28 compared to placebo in patients with heart failure (P = 0.03), but did not affect other outcomes.

Key Points

This research investigates the efficacy and safety of mirabegron, a beta 3 agonist, in patients with heart failure compared to a placebo.
Conducted a systematic review and meta-analysis of randomized controlled trials (RCTs)
Analyzed primary outcomes like heart rate, cardiac index, and adverse events
Included four studies with a total of 454 patients
Used inverse variance to compute risk ratios and mean differences
Mirabegron group showed significant improvement in cardiac index (MD: 0.28, P = 0.03)
No significant differences in heart rate, ejection fraction, stroke volume, or systolic blood pressure
No significant variations in adverse events between mirabegron and placebo groups
Safety outcomes showed no major differences in serious adverse events (RR: 1.06, p = 0.80)

Structured PICO

Does mirabegron improve hemodynamic parameters and safety outcomes in patients with heart failure?

Population

454 patients with heart failure (HF) pooled from 4 randomized controlled trials

Intervention

Mirabegron (beta 3 agonist)

Comparator

Placebo

Outcome

Heart rate, stroke volume, systolic blood pressure, cardiac index, and adverse eventssurrogate

In patients with heart failure, mirabegron improves cardiac index but does not significantly affect other hemodynamic parameters or increase adverse events compared to placebo.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

OBJECTIVE: Our goal is to conduct an investigation into the safety and efficacy of 𝛽3 agonist (Mirabegron) in patients with heart failure (HF) comparing it to placebo. METHODS: We searched internet databases for eligible randomized controlled trials (RCTs) up to April 1st, 2024. Heart rate, stroke volume, systolic blood pressure, cardiac index, and adverse events were the primary outcomes that were analyzed. Inverse variance was used to compute the risk ratio (RR) and pooled mean differences (MD), along with their 95% CI. RESULTS: Four studies were included in our paper with a total of 454 patients. The mirabegron group showed a statistically significant improvement compared to the placebo group in Cardiac index (MD: 0.28, 95% CI: 0.02 , 0.53, P = 0.03), but pooled analysis did not favor either of the two arms in heart rate, ejection fraction, stroke volume and systolic blood pressure (MD: 2.54, 95% CI: -1.05 , 6.13), (MD: 2.40, 95% CI: -2.51 , 7.3), (MD: 0.56, 95% CI: -2.45 , 3.56), and (MD: 0.11, 95% CI:-0.15 , 0.38) respectively. Furthermore, there were not significant variations between the two groups in adverse events, and serious adverse events (RR: 1.06, 95% CI: 0.87, 1.29), and (RR: 1.06, 95% CI: 0.70, 1.60, p = 0.80) respectively. CONCLUSION: The Cardiac index was considerably enhanced with Mirabegron, but all other effectiveness and safety outcomes were unchanged. Further RCTs for longer durations and on more diverse populations still need to be conducted.

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