[Meta-analysis of beta-adrenoceptor blockers for the treatment of vasovagal syncope].
OBJECTIVE
To summarize present randomized controlled trials and assess the effect of beta-adrenoceptor blockers on vasovagal syncope using meta-analysis method.


METHODS
According to inclusion and exclusion criteria, articles were selected from medical electronic databases searching, including PubMed (1968-2007), EMBASE (1991-2007), Elsevier (1990-2007) and CNKI (1990-2007). Randomized controlled trials (RCTs) were assessed based on the Juni assessment. Meta-analysis was completed using software Review Manager 4.2. Indication for evaluating effect was recurrence of syncope during follow-up or response in head-up tilt test (HUT). The results were stated as relative risk (RR) or odd ratio (OR) and their 95% confidence interval (CI), and P<0.05 showed significant differences.


RESULTS
Thirteen RCTs were selected finally. Funnle polt analysis showed publication bias might exist. Meta-analysis of 11 RCTs, including totally 460 patients in treatment group and 371 patients in control group, indicated patients in treatment group had lower rate of syncope recurrence as compared with control group (RR=0.61, 95%CI: 0.39-0.96, P=0.03). From 7 RCTs, including 166 patients in treatment group and 163 in control group, meta-analysis explored that patients in treatment group had higher rate of negative response in HUT at the end-point of follow-up as compared with control group (OR=9.15, 95%CI: 3.75-22.31, P<0.01).


CONCLUSIONS
The currently published RCTs support that beta-adrenoceptor blockers can be effective treatment of vasovagal syncope though the medicine was supposed to be not useful according to some well controlled studies. So, further large-scale multicentre and better designed study were still expected to give more convincing evidence.
Liao
Ying
Y
Department of Pediatrics, Peking University First Hospital, Beijing, China.
Li
Xue Ying
XY
Zhang
Yan Wu
YW
Du
Jun Bao
JB
D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention; D019462:Syncope, Vasovagal / Q000188:drug therapy*; D018667:Tilt-Table Test; D055815:Young Adult
D000319:Adrenergic beta-Antagonists