TOPCAT: Spironolactone in heart failure with preserved ejection fraction

The aldosterone blockade has shown benefit in the treatment of heart failure with systolic dysfunction after stroke. The aim of this study was to evaluate the effect of spironolactone in patients with preserved ejection fraction. This was a multicenter, randomized study that included 1722 patients in the spironolactone group and 1723 in the placebo group. All had symptomatic heart failure and ejection fraction greater than 45 %. At a mean follow 3.3 years, spironolactone showed no benefit in reducing the primary composite end point (HR = 0.89, CI 95% 0.77-1.04 , P = .14 ). Spironolactone did reduce the number of new hospitalizations for heart failure ( HR = 0.89 , CI 95% 0.63-0.89, P = .04). In the spironolactone group deterioration of renal function was observed and hyperkalemia, without this increasing incidence dialysis.

Conclusion:

Spironolactone in heart failure with preserved ejection fraction showed benefit only in terms of new admissions for heart failure at the expense of an increased risk of deterioration of renal function and hyperkalemia.

6_marc_pfeffer
Marc A. Pfeffer
2013-11-18

Original title: Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist

More articles by this author

VISTA 16: anti-inflammatory agent in acute coronary syndromes

There is evidence that inflammation would have an impact on the prognosis of patients experiencing acute coronary syndromes. The phospholipase A2 inhibitor Varespladib has...

Plastic versus mitral valve replacement in ischemic mitral regurgitation

Unlike degenerative mitral insufficiency, ischemic failure is due to an increase in the left ventricular cavity, the loss of its elliptical form, ring dilation...

MINERVA trial: DDDR versus DDDRP-MVP in patients with bradycardia

The sinus node disease is approximately 50 % of pacemaker implants. Atrial fibrillation is a frequent comorbidity of pacemakers and is associated with heart...

HF ROSE: Dopamine and Neseritide in heart failure associated with renal dysfunction

Previous small studies have suggested that low-dose dopamine or neseritide can enhance congestive signs of acute heart failure without altering renal function. 360 patients...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Evolution of Small Balloon-Expandable Valves

Small aortic rings (20 mm) have posed a significant challenge for both surgery and transcatheter aortic valve implantation (TAVI) due to their association with an...

TCT 2024 | Asymptomatic Severe Aortic Stenosis: What Should Be our Approach?

Approximately 3% of the population over 65 years old has aortic stenosis. Current guidelines recommend valve replacement for patients with symptoms or an ejection...

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...