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ACP Journal Club |

Spironolactone did not reduce cardiac outcomes in symptomatic heart failure with preserved ejection fraction

Ann Intern Med. 2014;161(8):JC6. doi:10.7326/0003-4819-161-8-201410210-02006
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Heart failure patients with preserved ejection fraction should avoid spironolatone
Posted on October 21, 2014
Gauranga Dhar
Bangladesh Institute of Family Medicine and Research
Conflict of Interest: None Declared
The Randomized Aldactone Evaluation Study (RALES) and some other studies proved that addition of spironolactone to standard therapy in patients with heart failure with reduced ejection fraction reduces all cause mortality but study on the effect of this mineralocorticoid antagonist in heart failure patients with preserved ejection fraction is sparse.
Treatment of Preserved Cardiac Function Heart failure with an Aldosterone Antagonist (TOPCAT) trial probably the largest trial with patients with heart failure with preserved ejection fraction of at least 45%.
In light of TOPCAT trial, we the physicians should modify the treatment strategy in this population.
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