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Review Article Open Access
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.
Acute heart failure syndrome, Nitrates, Vasodilator therapy, Morbidity, Mortality, Clinical Pediatric Emergency Medicine, Clinical Procedures in Emergency Medicine, Critical Decisions in Emergency Medicine, Emergency Care and Medicine, Emergency Care Nursing, Emergency Care Practice, Emergency Critical Care, Emergency Drugs, Emergency Internal Medicine