Pakistan Journal of Medical & Cardiological Review
Efficacy And Safety Of Combination Diuretic Therapy In Patients With Heart Failure: A Systematic Review And Meta-Analysis
By Pakistan Journal of Medical & Cardiological Review.
Abstract
Background
Persistent fluid overload is one of the hardest problems in heart failure (HF) care. Giving two or more diuretic classes together, for example metolazone with furosemide, has been suggested as a way to boost fluid removal and improve outcomes.
Objective
To judge the benefits and risks of combination diuretic strategies in patients with HF.
Methods
PubMed, the Cochrane Library, Embase and Web of Science were searched, yielding 61 records. Seven randomised controlled trials (RCTs) satisfied the eligibility criteria. Information on mortality, rehospitalisation, symptoms, electrolyte disturbance, kidney function and adverse events was extracted. Risk of bias was appraised with standard tools, and pooled estimates were produced with RevMan 5.4.0 using fixed- or random-effects models according to heterogeneity.