PMID- 24196866
OWN - NLM
STAT- MEDLINE
DCOM- 20140512
LR  - 20140320
IS  - 1538-2990 (Electronic)
IS  - 0002-9629 (Linking)
VI  - 347
IP  - 4
DP  - 2014 Apr
TI  - Effects of spironolactone on long-term mortality and morbidity in patients with 
      heart failure and mild or no symptoms.
PG  - 271-6
LID - 10.1097/MAJ.0b013e31829dd6b1 [doi]
AB  - BACKGROUND: The 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. METHODS: The 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. RESULTS: A 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. CONCLUSIONS: Administration 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.
FAU - Vizzardi, Enrico
AU  - Vizzardi E
AD  - Department of Experimental and Applied Medicine, University of Brescia, Brescia, 
      Italy.
FAU - Nodari, Savina
AU  - Nodari S
FAU - Caretta, Giorgio
AU  - Caretta G
FAU - D'Aloia, Antonio
AU  - D'Aloia A
FAU - Pezzali, Natalia
AU  - Pezzali N
FAU - Faden, Giacomo
AU  - Faden G
FAU - Lombardi, Carlo
AU  - Lombardi C
FAU - Raddino, Riccardo
AU  - Raddino R
FAU - Metra, Marco
AU  - Metra M
FAU - Dei Cas, Livio
AU  - Dei Cas L
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Am J Med Sci
JT  - The American journal of the medical sciences
JID - 0370506
RN  - 0 (Mineralocorticoid Receptor Antagonists)
RN  - 27O7W4T232 (Spironolactone)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Creatinine/blood
MH  - Disease-Free Survival
MH  - Female
MH  - Heart Failure/*drug therapy/mortality/physiopathology
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mineralocorticoid Receptor Antagonists/*therapeutic use
MH  - Morbidity
MH  - Prognosis
MH  - Single-Blind Method
MH  - Spironolactone/*therapeutic use
MH  - Treatment Outcome
MH  - Ventricular Function, Left/drug effects
EDAT- 2013/11/08 06:00
MHDA- 2014/05/13 06:00
CRDT- 2013/11/08 06:00
PHST- 2013/11/08 06:00 [entrez]
PHST- 2013/11/08 06:00 [pubmed]
PHST- 2014/05/13 06:00 [medline]
AID - S0002-9629(15)30358-X [pii]
AID - 10.1097/MAJ.0b013e31829dd6b1 [doi]
PST - ppublish
SO  - Am J Med Sci. 2014 Apr;347(4):271-6. doi: 10.1097/MAJ.0b013e31829dd6b1.