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Clinicians urged to consider spironolactone in HFPEF despite TOPCAT results
Date:5/18/2014

Athens, 18 May 2014: Clinicians have been urged to consider using spironolactone in their patients with heart failure and preserved ejection fraction (HFPEF) after a post-hoc analysis of the TOPCAT trial showed benefit in patients from the Americas.

The research was presented today at the Heart Failure Congress 2014 in Athens, Greece. The Congress is the main annual meeting of the Heart Failure Association of the European Society of Cardiology.

Professor Bertram Pitt said: "We've had many studies showing that ACE inhibitors, angiotensin receptor blockers, beta blockers and mineralocorticoid receptor blockers reduce mortality and hospitalisations in patients with heart failure and reduced ejection fraction (HFREF). But no studies have found a benefit of these medications in HFPEF patients."

He added: "The results of TOPCAT are complicated. The trial failed to meet its primary endpoint but post-hoc analysis has shown that spironolactone was beneficial in patients from the Americas. I think individual clinicians around the world need to look at the data and decide for themselves. If I was a clinician I would use spironolactone in my patients with HFPEF."

TOPCAT randomised 3445 patients with HFPEF to receive spironolactone, a mineralocorticoid receptor antagonist, at a dose of 15-45mg per day or placebo on top of usual care. Patients were recruited from 270 medical centres in 6 countries. Nearly half of the patients were from Russia and Georgia, and the remainder were from the Americas which included Canada, the US, Argentina and Brazil.

After a mean follow up of 3.3 years, the primary endpoint - which was a composite of reduction in cardiovascular mortality, resuscitated cardiac arrest and hospitalisation for heart failure - was reduced but was not reduced significantly.1 It occurred in 320 of 1722 patients
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Contact: ESC Press Office
press@escardio.org
33-622-834-576
European Society of Cardiology
Source:Eurekalert

Page: 1 2 3

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