作者
Bertram Pitt, Marc A Pfeffer, Susan F Assmann, Robin Boineau, Inder S Anand, Brian Claggett, Nadine Clausell, Akshay S Desai, Rafael Diaz, Jerome L Fleg, Ivan Gordeev, Brian Harty, John F Heitner, Christopher T Kenwood, Eldrin F Lewis, Eileen O'Meara, Jeffrey L Probstfield, Tamaz Shaburishvili, Sanjiv J Shah, Scott D Solomon, Nancy K Sweitzer, Song Yang, Sonja M McKinlay
发表日期
2014/4/10
期刊
New England Journal of Medicine
卷号
370
期号
15
页码范围
1383-1392
出版商
Massachusetts Medical Society
简介
Background
Mineralocorticoid-receptor antagonists improve the prognosis for patients with heart failure and a reduced left ventricular ejection fraction. We evaluated the effects of spironolactone in patients with heart failure and a preserved left ventricular ejection fraction.
Methods
In this randomized, double-blind trial, we assigned 3445 patients with symptomatic heart failure and a left ventricular ejection fraction of 45% or more to receive either spironolactone (15 to 45 mg daily) or placebo. The primary outcome was a composite of death from cardiovascular causes, aborted cardiac arrest, or hospitalization for the management of heart failure.
Results
With a mean follow-up of 3.3 years, the primary outcome occurred in 320 of 1722 patients in the spironolactone group (18.6%) and 351 of 1723 patients in the placebo group (20.4%) (hazard ratio, 0.89; 95% confidence interval [CI], 0.77 to 1.04; P=0.14). Of the …
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B Pitt, MA Pfeffer, SF Assmann, R Boineau, IS Anand… - New England Journal of Medicine, 2014