Perbandingan Efek Samping ARNI vs ACEi/ARB pada Terapi Gagal Jantung
Analisis
DOI:
https://doi.org/10.55175/cdk.v52i5.1314Kata Kunci:
ACEi, ARB, ARNI, gagal jantungAbstrak
Pendahuluan: Tata laksana farmakologi gagal jantung terus berkembang. Berbagai obat baru seperti ARNI (angiotensin receptor neprilysin inhibitor) masuk dalam standar pengobatan gagal jantung. Tinjauan sistematik ini bertujuan untuk membandingkan antara efek samping ARNI dan terapi standar gagal jantung sebelumnya. Metode: Penelitian ini menggunakan kaidah PRISMA untuk analisis artikel-artikel yang berasal dari PubMed dan Cochrane. Hasil: Total terdapat 2.741 artikel, tidak termasuk duplikat yang dipilih untuk dilakukan skrining judul dan abstrak. Terdapat 12 artikel yang memenuhi syarat untuk skrining menyeluruh. Dari 12 artikel, 4 artikel dipilih untuk analisis tinjauan sistematis. Terdapat 6.553 sampel, 2.580 di kelompok ARNI dan 2.390 di kelompok ACEi/ARB. Kelompok ARNI lebih baik dalam menurunkan risiko penurunan eGFR (RR: 0,51; 0,34-0,78) dan kejadian hiperkalemia (RR: 0,87; 0,76-0,99) tetapi risiko hipotensi simtomatik lebih besar (RR: 1,47; 1,23-1,70). Simpulan: Risiko hipotensi serta penurunan risiko kematian kardiovaskular dan rehospitalisasi lebih tinggi pada kelompok ARNI, sedangkan risiko penurunan eGFR dan hiperkalemia lebih tinggi pada kelompok ACEi/ARB.
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Referensi
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