ObjectiveTo systematically review the efficacy of irbesartan combined with metoprolol plus conventional treatment compared with single drug (irbesartan, metoprolol) plus conventional treatment or conventional treatment for elderly patients with severe heart failure.MethodsPubMed, The Cochrane Library, Web of Science, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on irbesartan combined with metoprolol in the treatment of elderly patients with severe heart failure from January 2009 to September 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Network meta-analysis was then performed using gemtc package of R software.ResultsA total of 58 RCTs involving 5 064 patients were included. The results of meta-analysis showed that the efficiency, left ventricular ejection fraction (LVEF) and brain natriuretic peptide (BNP) of combination group were significantly superior to single drug group.ConclusionsThe current evidence shows that under the premise of conventional treatment, the combination of irbesartan and metoprolol is more effective than irbesartan or metoprolol alone in the treatment of elderly patients with severe heart failure. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
The R software bmeta package is a package that implements Bayesian meta-analysis and meta-regression by invoking JAGS software. The program is based on the Markov Chain Monte Carlo (MCMC) algorithm to combine various effect quantities (OR, MD and IRR) of different types of data (dichotomies, continuities and counts). The package has the advantages of fewer command function parameters, rich models, powerful drawing function, easy of understanding and mastering. In this paper, an example is presented to demonstrate the complete operation flow of bmeta package to implement bayesian meta-analysis and meta-regression.