Key result
Angiotensin-converting enzyme inhibitors showed no difference in effect versus angiotensin receptor blockers in heart failure patients with type 2 diabetes (RR 1.73; 95% CI 0.88-3.40; p=0.11).
Why the study?
Heart failure is prevalent worldwide and both ACE inhibitors and ARBs are widely prescribed, motivating a determination of the effect of the two drugs in heart failure patients with type 2 diabetes mellitus.
Do angiotensin-converting enzyme inhibitors improve outcomes compared to angiotensin receptor blockers in heart failure patients with type 2 diabetes mellitus?
Meta-Analysis
Do angiotensin-converting enzyme inhibitors improve outcomes compared to angiotensin receptor blockers in heart failure patients with type 2 diabetes mellitus?
This meta-analysis suggests no significant difference in efficacy between ACE inhibitors and ARBs in patients with concurrent heart failure and type 2 diabetes mellitus.
No significant difference between ACE inhibitors and ARBs in HF with T2DM; leaves open agent selection pending higher-certainty trials.
Abstract:Introduction: Heart failure is a prevalent world wide. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are widely prescribed. The aim of this study was to determine the effect of the two drugs in heart failure patients with type 2 diabetes mellitus.Methods: This meta-analysis was performed on research articles on the drugs of heart failure patients in PubMed, ProQuest and EBSCO database published between 2008-2018. Pooled odds ratio (OR) are calculated using fixed and random effects models. Data were processed using Review Manager 5.3 (RevMan 5.3).Results: From total 209 articles, 10 studies met the criteria for systematic review. Meta-analysis result showed that there were no difference effect of angiotensin-converting enzyme inhibitors versus angiotensin receptor blockers in heart failure patients with type 2 diabetes mellitus (RR = 1.73 [95% CI 0.88-3.40], p=0.11). Heterogeneity test for studies (Pheterogeneity = <0.00001) showed variation of heterogeneous research. There is no publication bias on this study Egger’s test (p = 0.334) and Begg’s test (p = 0.180).Conclusion: This analysis confirmed there were no difference effect of angiotensin-converting enzyme inhibitors (ACEi) versus angiotensin receptor blockers (ARBs) in heart failure patients with type 2 diabetes mellitus
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Febrinasari et al. (2019) conducted a meta-analysis in Heart failure with type 2 diabetes mellitus. Angiotensin-Converting Enzyme Inhibitors vs. Angiotensin Receptor Blockers was evaluated on Overall effect (RR 1.73, 95% CI 0.88-3.40, p=0.11). Angiotensin-converting enzyme inhibitors showed no difference in effect versus angiotensin receptor blockers in heart failure patients with type 2 diabetes (RR 1.73; 95% CI 0.88-3.40; p=0.11).
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