Outcome definition
The primary endpoints for the present study were left ventricular ejection fraction (LVEF) decline and congestive heart failure (CHF); LVEF decline was defined as LVEF decline less than 50% or a decrease of more than 10% from baseline, while CHF defined as New York Heart Association (NYHA) class III or IV or cardiac death. To avoid loss of information, trials reported LVEF decline more than 15% or 20% from baseline was also regarded as LVEF decline in the present analysis.