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Glucocorticoids for Patients With Acute Decompensated Heart Failure: A Protocol for a Systematic Review With
Laura Wrisberg Kæstel1, Isak Mazanti Cold1,2, Danni Herman Andersen3
1Department of Cardiology, Copenhagen University Hospital ̶ Amager-Hvidovre Hospital, Copenhagen, Denmark.
Acta Anaesthesiologica Scandinavica
|May 22, 2026
Summary
Glucocorticoids may offer a therapeutic benefit for acute decompensated heart failure (ADHF) by reducing inflammation. This systematic review will analyze randomized trials to assess their effectiveness and impact on mortality in ADHF patients.
Area of Science:
- Cardiology
- Pharmacology
- Systematic Review Methodology
Background:
- Acute decompensated heart failure (ADHF) is linked to systemic inflammation.
- Elevated inflammatory biomarkers in ADHF patients correlate with increased mortality.
- Glucocorticoids possess anti-inflammatory properties, suggesting potential therapeutic value in ADHF.
Purpose of the Study:
- To systematically review and meta-analyze randomized controlled trials (RCTs) evaluating the efficacy of glucocorticoids as an adjunct to standard care for ADHF.
- To assess the impact of glucocorticoids on all-cause mortality and other clinical outcomes in hospitalized ADHF patients.
- To identify research gaps and inform future clinical investigations.
Main Methods:
- Systematic review and meta-analysis adhering to Cochrane Handbook and PRISMA protocols.
- Comprehensive literature search across major databases (Medline, Embase, CENTRAL, LILACS, Web of Science).
- Inclusion of RCTs comparing glucocorticoids with placebo or other controls in hospitalized ADHF patients; assessment of risk of bias and certainty of evidence (GRADE).
Main Results:
- Primary outcome: all-cause mortality.
- Secondary outcomes: length of hospitalization, all-cause hospitalizations, and heart failure rehospitalization.
- Trial Sequential Analysis will be performed to enhance the reliability of meta-analysis findings.
Conclusions:
- This systematic review will synthesize evidence on glucocorticoids for ADHF.
- The study aims to determine the therapeutic potential of glucocorticoids in ADHF management.
- Findings will guide future research directions in ADHF treatment.
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