aldosterone blockers, spironolactone
DISEASE INTERVENTION COMPARISON RESULTS
N Engl J Med. 2014 Apr 10;370(15):1383-92 Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic, diastolic (preserved ejection fraction) The Use of
aldosterone blockers, spironolactone
As Treatment, Chronic
Is equal Than
placebo
To modify clinical events (cardiovascular death or hospitalization for heart failure) at 3 years: 18.6% spironol. VS 20.4% placebo). Only hospitalizations for HF were reduced (12% spironol. VS 14.2% placebo) but not hospitalizations by any reason
Cochrane Database Syst Rev. 2018 06 28;6():CD012721 Systematic Review, Cochrane Review
IN heart failure, chronic, diastolic (preserved ejection fraction) The Use of
various medical treatments: angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), beta blockers, aldosterone blockers, spironolactone
As Treatment, Chronic
Is undefined Than
placebo
To Aldosterone blockers reduce heart failure hospitalisations (11% aldost blockers VS 14% controls). Beta-blockers might reduce cardiovascular mortality (15% BB VS 19% placebo) but inconsistent evidence. ACEI and ARB did not seem to have any effect
Heart. 2018 Mar;104(5):407-415 Meta-Analysis
IN heart failure, chronic, diastolic (preserved ejection fraction) The Use of
various medical treatments: angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), beta blockers, aldosterone blockers, spironolactone
As Treatment, Chronic
Is equal Than
placebo
To modify survival (except beta blockers, associated with reduced all-cause and cardiac deaths, (RR: 0.78) or reduce rehospitalizations or improve functional capacity
N Engl J Med. 1999 Sept 2;341(10):709-17 Randomized Controlled Trial
IN heart failure, chronic, systolic, severe The Use of
aldosterone blockers, spironolactone, added to loop diuretics and ACEI
As Treatment, Chronic
Is better Than
placebo
To reduce overall mortality, at 2 years: 35% in intv. VS 46% in ctrl. Reduce cardiac hospitalizations and significantly improve NYHA class