May 26, 2020Open Access
View Full PaperSpironolactone Dose in Heart Failure with Preserved Ejection Fraction: Findings from TOPCAT
Structured PICO
Does a low-dose spironolactone strategy maintain its effect compared to target doses in patients with heart failure with preserved ejection fraction?
P
Population
Patients with Heart Failure with Preserved Ejection Fraction (HFpEF)
I
Intervention
Spironolactone (low-dose strategy)
C
Comparator
Placebo
In HFpEF patients unable to tolerate target doses of spironolactone, a low-dose strategy maintains a homogeneous treatment effect and should be preferred to stopping treatment.
Abstract
Spironolactone (but not placebo) was used at lower doses among the elderly, those with renal dysfunction and with higher potassium levels. The effect of spironolactone was homogeneous across these subgroups. In patients unable to tolerate target doses, a low-dose strategy should be preferred to stopping treatment.