Key result
Eplerenone did not significantly reduce the primary composite of cardiovascular death or heart failure hospitalization compared with spironolactone (HR 0.95; 95% CI 0.73-1.27; P=0.675).
Why the study?
MRAs are recommended to reduce HF hospitalization and death, but head-to-head efficacy data comparing eplerenone versus spironolactone on LV systolic function and clinical outcomes in chronic HFrEF were needed.
Does eplerenone reduce cardiovascular death or heart failure hospitalization compared to spironolactone in patients with chronic HFrEF?
Population
142 patients with chronic HFrEF
Comparison
Eplerenone vs spironolactone
Design
Randomized prospective single-blind trial
Follow-up
12 months
Authors
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May continue using either MRA without preference in chronic HFrEF; confirms comparable primary-endpoint efficacy and extends head-to-head MRA data.
RCT (n=142)
Single-blind
randomized
Does eplerenone reduce cardiovascular death or heart failure hospitalization compared to spironolactone in patients with chronic HFrEF?
Hazard Ratio: 0.95 (95% CI 0.73–1.27)
p-value: p=0.675
In patients with chronic HFrEF, eplerenone improved left ventricular systolic function and reduced cardiovascular mortality compared to spironolactone, although it did not significantly reduce the primary composite outcome of cardiovascular death or HF hospitalization.
Naser et al. (2023) conducted an RCT in chronic heart failure with reduced ejection fraction (n=142). Eplerenone vs. Spironolactone was evaluated on cardiovascular death or hospitalization due to HF (HR 0.95, 95% CI 0.73-1.27, p=0.675). Eplerenone did not significantly reduce the primary composite of cardiovascular death or heart failure hospitalization compared with spironolactone (HR 0.95; 95% CI 0.73-1.27; P=0.675).
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