Key result
High-dose spironolactone links to a ~14% higher total effective rate versus low-dose in CHF.
Why the study?
To explore the short-term effect of high-dose spironolactone (80 mg/d) on chronic congestive heart failure.
Does short-term high-dose spironolactone (80 mg/d) improve cardiac function and reduce natriuretic peptide levels more effectively than low-dose spironolactone (40 mg/d) in patients with chronic congestive heart failure?
Observational (n=211)
No
Does short-term high-dose spironolactone (80 mg/d) improve cardiac function and reduce natriuretic peptide levels more effectively than low-dose spironolactone (40 mg/d) in patients with chronic congestive heart failure?
Absolute Event Rate: 92.68% vs 81.39%
p-value: p=0.027
Short-term use of high-dose spironolactone (80 mg/d) in patients with chronic congestive heart failure significantly improves cardiac function, exercise tolerance, and reduces natriuretic peptide levels compared to low-dose (40 mg/d) therapy, without causing hyperkalemia.
High-dose spironolactone was associated with higher response rates in chronic heart failure; leaves open confirmation of benefit and safety in randomized trials.
To explore the short-term effect of high-dose spironolactone (80 mg/d) on chronic congestive heart failure (CHF).The general clinical data of 211 patients with CHF from February 2016 to August 2019 were collected and analyzed. Patients were divided into Low-dose group (taking 40 mg/d spironolactone) and High-dose group (taking 80 mg/d spironolactone) according to the patient's previous dose of spironolactone. The changes of B-type brain natriuretic peptide (BNP), NT-pro BNP (N terminal pro B type natriuretic peptide), echocardiography, 6-minute walking test (6MWT), and comprehensive cardiac function assessment data were collected for analysis.Compared with before treatment, the blood potassium of the two groups increased significantly (P < .05), but the blood potassium did not exceed the normal range. Compared with before treatment, BNP, NT-pro BNP, LVEDD, LVEDV and NYHA grading were significantly decreased (P < .05), LVEF and 6-MWT were significantly increased (P < .05). Compared with the Low-dose group, the high-dose group BNP (117.49 ± 50.32 vs 195.76 ± 64.62, P < .05), NT-pro BNP (312.47 ± 86.28 vs 578.47 ± 76.73, P < .05), LVEDD (45.57 ± 5.69 vs 51.96 ± 5.41, P <.05), LVEDV (141.63 ± 51.14 vs 189.85 ± 62.49, P < .05) and NYHA grading (1.29 ± 0.41 vs 1.57 ± 0.49, P < .05) were significantly reduced, but, 6-MWT (386.57 ± 69.72 vs 341.73 ± 78.62, P < .05), LVEF (41.62 ± 2.76 vs 36.02 ± 2.18, P < .05) and total effective rate (92.68% vs 81.39%, P < .05) increased significantly.Compared with 40 mg spironolactone, 80 mg spironolactone can rapidly reduce BNP and NT-pro BNP concentration, enhance exercise tolerance, improve clinical signs and cardiac function classification, and has better efficacy.
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Pan et al. (2021) conducted an observational in chronic congestive heart failure (n=211). spironolactone vs. spironolactone 40 mg/d was evaluated on Total effective rate (p=0.027). High-dose spironolactone (80 mg/d) significantly increased the total effective rate to 92.68% compared to 81.39% with low-dose spironolactone (40 mg/d) in patients with chronic congestive heart failure.
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