TOPCAT misses its primary endpoint: Should spironolactone be abandoned in HFpEF?
نویسنده
چکیده
Heart failure with preserved ejection fraction (HFpEF) continues to be a challenging form of heart failure - one in which no therapy has yet been proven to improve outcome. Aldosterone antagonists have previously been shown to improve survival in a wide spectrum of patients with heart failure with reduced ejection fraction (HFrEF), and more recently, small trials suggested that they might have role in HFpEF patients. The effect of spironolactone on clinical outcomes in HFpEF was tested in the TOPCAT study.
منابع مشابه
Baseline characteristics of patients in the treatment of preserved cardiac function heart failure with an aldosterone antagonist trial.
BACKGROUND Treatment of Preserved Cardiac Function with an Aldosterone Antagonist (TOPCAT) is an ongoing randomized controlled trial of spironolactone versus placebo for heart failure with preserved ejection fraction (HFpEF). We sought to describe the baseline clinical characteristics of subjects enrolled in TOPCAT relative to other contemporary observational studies and randomized clinical tri...
متن کاملA better understanding to improve treatment of heart failure and preserved ejection fraction
The year 2014 has become a remarkable year for heart failure. A bad start was caused by the publication of TOPCAT, showing that spironolactone did not prove to be beneficial for the treatment of patients with heart failure and preserved ejection fraction (HFpEF). Nevertheless, further insights in the study yields a few bright spots, and treatment with spironolactone might still be considered in...
متن کاملSpironolactone in cardiovascular disease: an expanding universe?
Spironolactone has been marketed for over half a century as a 'potassium-sparing diuretic', used primarily in patients with ascites. With the realization that primary aldosteronism is the most common (5-13%) form of secondary hypertension, it has become widely used as a mineralocorticoid receptor antagonist. More recently, in the wake of the RALES trial, spironolactone in addition to standard t...
متن کاملLessons from the TOPCAT trial.
Some patients with the clinical syndrome of heart failure have a normal or near-normal left ventricular ejection fraction.1-3 To date, no treatment has been shown to improve outcomes in this condition, usually designated heart failure with a preserved ejection fraction.2,3 The care of such patients can be difficult and is typically limited to efforts to relieve symptoms. Mineralocorticoid-recep...
متن کاملRegional variation in patients and outcomes in the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) trial.
BACKGROUND Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) patients with heart failure and preserved left ventricular ejection fraction assigned to spironolactone did not achieve a significant reduction in the primary composite outcome (time to cardiovascular death, aborted cardiac arrest, or hospitalization for management of heart failure) compared...
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ورودعنوان ژورنال:
دوره 2013 شماره
صفحات -
تاریخ انتشار 2013