Aaron James P. Tan,
Ma. Angela C. Anacleto
Book of Abstracts
Publication Sub Type
CSMC Research Abstract Compendium
BACKGROUND: Heart failure (HF) is a healthcare problem affecting the entire world population. Hyponatremia, one of the complications of HF, is an independent predictor of mortality, hospitalization, and death7. Recently Tolvaptan, an oral vasopressin antagonist which acts as a selective, competitive vassopresin receptor 2 antagonist, has been approved by the Food and Drug Administration (FDA) to treat hyponatremia associated with congestive heart failure, cirrhosis and the syndrome of inappropriate antidiuretic hormone.5, 6 This study aims to determine if Tolvaptan can decrease mortality among hospitalized hyponatremic patients with CHF.
METHODS: An independent online search by two authors of MEDLINE and PubMed was utilized. Search term to used include "Tolvaptan", "Congestive Heart Failure", "Mortality" and "Hyponatremia". Selection of studies was limited to randomized controlled trials involving human subjects.
RESULTS: 3 trials were included in the analysis for the effect of Tolvapatan on the mortality of hospitalized CHF patients with a total number of 2431 subjects treated with Tolvaptan and 2261 subjects treated with placebo. Heterogeneity was nott significant among the trials with an I2 of 18%. Tolvaptan did not show a significant effect in decreasing mortality (RR, 0.97; 95% CI, 0.88, 1.07).
CONCLUSION: The results of this meta-analysis did not demonstrate that the addition of Tolvaptan had a significant effect in the mortality of hospitalized HF patients on top of standard heart failure regimens. A trial of Tolvaptan on hyponatremic, HF patients, early in the disease course and who are still responsive to diuresis may provide better insight if treatment with Tolvaptan can affect mortality in CHF.