Effects of Spironolactone on Long-term Mortality and Morbidity in Patients With Heart Failure and Mild or No Symptoms |
| |
| Institution: | From the Department of Experimental and Applied Medicine, University of Brescia, Brescia, Italy.;From the Department of Internal Medicine, and Division of Cardiology, SUNY Upstate Medical University, Syracuse, New York;Veterans Affairs Medical Center, Syracuse, New York;Division of Nephrology Department of Internal Medicine University of Iowa Hospitals and Clinics Iowa City, Iowa;From the Research Division, Ochsner Clinic Foundation, Ochsner Health System, New Orleans, Louisiana.;Divisions of Cardiovascular Medicine, Stanford University Hospital, Stanford, California.;Critical Care Medicine, Stanford University Hospital, Stanford, California.;Pulmonary and Critical Care Medicine, Stanford University Hospital, Stanford, California.;Department of Medicine and Departments of Anesthesia, Stanford University Hospital, Stanford, California.;Pharmacy, Stanford University Hospital, Stanford, California.;Pulmonary and Critical Care Medicine, Stanford University Hospital, Stanford, California.;Pulmonary and Critical Care Medicine, Stanford University Hospital, Stanford, California.;Department of Medicine and Departments of Anesthesia, Stanford University Hospital, Stanford, California.;Division of Infectious Diseases Department of Medicine The University of Tennessee Health Science Center, Memphis, Tennessee;Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan |
| |
| Abstract: | BackgroundThe purpose of this study is to evaluate long-term effects of spironolactone, an affordable and widely used aldosterone receptor blocker, in patients with heart failure (HF) and mild or no symptoms.MethodsThe study is a single-blind, placebo-controlled, blinded endpoint, randomized study. Patients with New York Heart Association (NYHA) classes I to II HF and left ventricular ejection fraction < 40% were randomized to spironolactone or placebo in addition to optimal therapy. The primary endpoint was the composite of death from any cause or cardiovascular hospitalization.ResultsA total of 130 patients were randomized to spironolactone (n = 65) or placebo (n = 65). Patients on spironolactone had a better event-free survival for cardiovascular death or cardiovascular hospitalizations and for cardiovascular hospitalizations alone. At multivariable analysis, only spironolactone therapy, left ventricular ejection fraction and serum creatinine levels had an independent prognostic value for the combined endpoint, whereas only spironolactone therapy and serum creatinine levels had an independent prognostic value for cardiovascular hospitalizations alone.ConclusionsAdministration of spironolactone reduced the composite of death and cardiovascular hospitalization in patients with NYHA classes I to II HF. These results suggest that spironolactone could be beneficial when administered on top of optimal therapy among patients with HF and mild or no symptoms. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
