title: Milrinone for the Treatment of Acute Heart Failure After Acute Myocardial Infarction: A Systematic Review and Meta-Analysis.
abstract: Despite advancements in modern medicine, the treatment of acute heart failure (AHF) after acute myocardial infarction (AMI) remains challenging. Milrinone is effective in the treatment of chronic congestive heart failure, but its safety and efficacy in patients with AHF after AMI have not been systematically evaluated. This meta-analysis was performed to assess the safety and efficacy of milrinone in patients with AHF after AMI. We used a pre-designed protocol to search electronic databases for randomized trials assessing milrinone for the treatment of AHF after AMI. Data were abstracted from relevant studies. Heterogeneity was assessed qualitatively using a Q test and quantified using the I(2) statistic. Pooled risk estimates with 95% confidence intervals (CIs) were obtained using fixed-effects models unless substantial heterogeneity was observed (I(2) ≥ 50% and heterogeneity p ≤ 0.1). Four randomized trials met the inclusion criteria. However, there were no significant differences in deaths, blood pressure, premature ventricular contractions, gastrointestinal reactions, or ventricular tachycardia or fibrillation (all p > 0.05) between control group and milrinone treatment group. Pooled estimates showed that milrinone significantly increased the left ventricular ejection fraction (MD 5.69; 95% CI 4.27 to 7.10; p < 0.00001) and cardiac output (MD 0.35, 95% CI: 0.13 to 0.56; p = 0.002, I(2) = 24%). While studies to date are few and limited by small sample sizes and poor quality, they suggest that treatment with milrinone may be safe and effective for patients with AHF after AMI. However, this meta-analysis did not show that milrinone could improve prognosis or the survival rate.
authors.affiliation: Department of Cardiology, Zhujiang Hospital, Southern Medical University, GuangZhou, GuangDong, China.|Department of Cardiology, The First Hospital of QinHuangDao, QinHuangDao, HeBei, China.
authors.forename: Xiuying
authors.initials: X
authors.lastname: Tang
authors.affiliation: Department of Cardiology, Zhujiang Hospital, Southern Medical University, GuangZhou, GuangDong, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Liu
authors.affiliation: Department of Emergency Medicine, The First Hospital of QinHuangDao, QinHuangDao, HeBei, China.
authors.forename: Runjun
authors.initials: R
authors.lastname: Li
authors.affiliation: Department of Cardiology, General Hospital of Shenyang Military Area Command, Shenyang, LiaoNing, China.
authors.forename: Quanmin
authors.initials: Q
authors.lastname: Jing
authors.affiliation: Department of Cardiology, Zhujiang Hospital, Southern Medical University, GuangZhou, GuangDong, China.
authors.forename: Junhao
authors.initials: J
authors.lastname: Lv
authors.affiliation: Department of Pharmaceutical Science, Zhujiang Hospital, Southern Medical University, GuangZhou, GuangDong, China.
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Zhujiang Hospital, Southern Medical University, GuangZhou, GuangDong, China.
authors.forename: Yingfeng
authors.initials: Y
authors.lastname: Liu
mesh_terms: D002316:Cardiotonic Agents / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D020105:Milrinone / Q000627:therapeutic use*; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy*
chemical_list: D002316:Cardiotonic Agents; D020105:Milrinone