Nitrates for the Management of Acute Heart Failure SyndromesAhmad Shoaib1*, Mohamed Farag2 and Diana A Gorog3
- Corresponding Author:
- Ahmad Shoaib
Academic Cardiology, University of Hull, UK
E-mail: [email protected]
Received Date: September 07, 2015; Accepted Date: April 21, 2016; Published Date: April 28, 2016
Citation: Shoaib A, Farag M, Gorog DA (2016) Nitrates for the Management of Acute Heart Failure Syndromes. Emerg Med (Los Angel) 6:320. doi:10.4172/2165-7548.1000320
Copyright: © 2016 Shoaib A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Intravenous nitrates are widely used in the management of acute heart failure syndrome (AHFS), yet with lack of robust evidence to support their use. We therefore sought to analyse all randomised studies that evaluated the effects of nitrates on clinical outcomes in patients with AHFS. In total, fifteen relevant trials comparing nitrates and alternative interventions in 1824 patients were identified. All but three were conducted before 1998. No trials demonstrated a beneficial effect on mortality, apart from one trial reporting a reduction in mortality, which was related to the time of treatment. Retrospective review suggests that there is a lack of data to draw any firm conclusions concerning the use of nitrates in patients with AHFS, which is surprising given the widespread use of nitrates. More studies are needed to evaluate the safety and efficacy of these agents in the modern era of guideline-directed use of heart failure therapy.