Aldosterone receptor antagonists decrease mortality and cardiovascular hospitalizations in chronic heart failure (CHF) with reduced left ventricular ejection fraction(LVEF), but not in CHF with preserved LVEF. A meta-analysis of randomized controlled trials.

CONCLUSIONS: Our meta-analysis provides further evidence that ARAs should be systematically used in patients with HFREF , in whom these drugs improve some hard clinical endpoints, such as all-cause mortality and hospitalizations from cardiac cause. Conversely, based on the present meta-analysis, ARA usage in HFpEF patients is questionable since in this CHF setting no significant improvement in clinical endpoints has been demonstrated so far, in the face of the well-known risks of hyperkalemia and/or gynecomastia that chronic ARA therapy entails. Furthermore, new selective ARAs are not burdened by significant risk of gynecomastia, while are similar to nonselective ARAs with regard to the efficacy profile as well as to the risk of eliciting hyperkalemia. PMID: 27958695 [PubMed - as supplied by publisher]
Source: Minerva Cardioangiologica - Category: Cardiology Tags: Minerva Cardioangiol Source Type: research