title: Efficacy and safety of mineralocorticoid receptor antagonists for patients with heart failure and diabetes mellitus: a systematic review and meta-analysis.
abstract: BACKGROUND
  The aim of this study was to systematically assess the efficacy and safety of mineralocorticoid receptor antagonists (MRAs) for patients with heart failure (HF) and diabetes mellitus (DM).
  
  
  METHODS
  We conducted a comprehensive search for controlled studies that evaluated the efficacy and safety of MRAs in patients with DM and HF. Medline, Embase and Cochrane databases were searched. Two reviewers independently identified citations, extracted data and evaluated quality. Risk estimations were abstracted and pooled where appropriate.
  
  
  RESULTS
  Four observational studies were included. MRAs use was associated with reduced mortality compared with controls (RR = 0.78; 95% CI: 0.69-0.88; I(2) = 0%; P < 0.001). Increased risk of developing hyperkalaemia was observed in those patients taking MRAs (RR = 1.74; 95% CI: 1.27-2.38; I(2) = 0%; P = 0.0005).
  
  
  CONCLUSIONS
  The current cumulative evidence suggests that MRAs can improve clinical outcomes but increase the risk of hyperkalaemia in patients with DM and HF.
  
  
  BACKGROUND
  PROSPERO CRD42015025690 .
authors.affiliation: Diabetes Center and Department of Endocrinology, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, 325027, Wenzhou, Zhejiang, China. cmd1001@126.com.
authors.forename: Meng-Die
authors.initials: MD
authors.lastname: Chen
authors.affiliation: Diabetes Center and Department of Endocrinology, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, 325027, Wenzhou, Zhejiang, China. thinky183@163.com.
authors.forename: Si-Si
authors.initials: SS
authors.lastname: Dong
authors.affiliation: Department of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, 325027, Wenzhou, Zhejiang, China. 425465797@qq.com.
authors.forename: Ning-Yu
authors.initials: NY
authors.lastname: Cai
authors.affiliation: Diabetes Center and Department of Endocrinology, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, 325027, Wenzhou, Zhejiang, China. 530693328@qq.com.
authors.forename: Meng-Di
authors.initials: MD
authors.lastname: Fan
authors.affiliation: Diabetes Center and Department of Endocrinology, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, 325027, Wenzhou, Zhejiang, China. 1183659530@qq.com.
authors.forename: Su-Ping
authors.initials: SP
authors.lastname: Gu
authors.affiliation: Diabetes Center and Department of Endocrinology, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, 325027, Wenzhou, Zhejiang, China. 1902941092@qq.com.
authors.forename: Jin-Jue
authors.initials: JJ
authors.lastname: Zheng
authors.affiliation: Diabetes Center and Department of Endocrinology, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, 325027, Wenzhou, Zhejiang, China. 1184187230@qq.com.
authors.forename: Hai-Min
authors.initials: HM
authors.lastname: Yin
authors.affiliation: Diabetes Center and Department of Endocrinology, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, 325027, Wenzhou, Zhejiang, China. 2206251@qq.com.
authors.forename: Xin-He
authors.initials: XH
authors.lastname: Zhou
authors.affiliation: Diabetes Center and Department of Endocrinology, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, 325027, Wenzhou, Zhejiang, China. 1252182270@qq.com.
authors.forename: Liang-Xue
authors.initials: LX
authors.lastname: Wang
authors.affiliation: Diabetes Center and Department of Endocrinology, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, 325027, Wenzhou, Zhejiang, China. 370677036@qq.com.
authors.forename: Chun-Ying
authors.initials: CY
authors.lastname: Li
authors.affiliation: Diabetes Center and Department of Endocrinology, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, 325027, Wenzhou, Zhejiang, China. wallbb_1022@163.com.
authors.forename: Chao
authors.initials: C
authors.lastname: Zheng
mesh_terms: D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D006333:Heart Failure / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D006947:Hyperkalemia / Q000453:epidemiology*; D000451:Mineralocorticoid Receptor Antagonists; D009026:Mortality; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000451:Mineralocorticoid Receptor Antagonists
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