Evidence map›Paper›PMID 26408016›Full record

ReviewCurrent atherosclerosis reports2015

Spironolactone for Management of Heart Failure with Preserved Ejection Fraction: Whither to After TOPCAT?

Sumeet S Mitter, Sanjiv J Shah

Abstract readReview
PubMed Publisher
In one paragraph

Review in Current atherosclerosis reports, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
2.0field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 19 citations in OpenAlex.

  1. Review
  2. Review
  3. Review
  4. Observational
  5. Article
  6. Review
  7. Review
  8. Review
  9. Review
  10. Review
  11. The heart in sickle cell disease, a model for heart failure with preserved ejection fraction.Proceedings of the National Academy of Sciences of the United States of America · 2016
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

Sumeet S MitterDivision of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 N. St. Clair Street, Suite 600, Chicago, IL, 60611, USA.
Sanjiv J ShahDivision of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 N. St. Clair Street, Suite 600, Chicago, IL, 60611, USA. sanjiv.shah@northwestern.edu.
Northwestern University · US

Funding

Transition from Risk Factors to Early HF: Prevalence, Pathogenesis, and PhenomicsR01HL127028 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI BERTONI, ALAIN GERALD, SHAH, SANJIV J · 2015 to 2018
$6.5M
Study of Cardiac Mechanics in Systemic HypertensionR01HL107577 · NHLBI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI SHAH, SANJIV J · 2011 to 2019
$4.1M
NHLBI NIH HHS R01 HL107577NHLBI NIH HHS R01 HL127028
6 · The paper itself

Abstract

Mineralocorticoid receptor antagonists (MRAs) represent an attractive class of drugs for the treatment of heart failure with preserved ejection fraction (HFpEF) because of the deleterious cardiovascular effects of aldosterone and because MRAs combat myocardial fibrosis and improve cardiac structure/function and vascular health. Recently, the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) study, a randomized, double-blind clinical trial of spironolactone versus placebo, was conducted in 3445 patients with symptomatic HFpEF. Although considered by some to be a negative trial, TOPCAT demonstrated that spironolactone decreases heart failure hospitalizations in patients with HFpEF. Furthermore, a pre-specified subgroup analysis of TOPCAT by geographic region uncovered concerning findings from Russia/Georgia, questioning (1) whether the correct patients were enrolled in this region and (2) whether enrolled patients actually received the study drug. In the Americas, spironolactone was clearly superior to placebo in reducing cardiovascular events. Given these data from TOPCAT, basic science evidence for the role of aldosterone in HFpEF, and results from other MRA clinical trials in HFpEF, we advocate using spironolactone in HFpEF with close monitoring of potassium and renal function.

Indexed as

AldosteroneHeart FailureHumansMineralocorticoid Receptor AntagonistsRandomized Controlled Trials as TopicSpironolactoneTreatment OutcomeAldosteroneMineralocorticoid Receptor AntagonistsSpironolactoneHeart failure with preserved ejection fractionMineralocorticoid receptor antagonistsOutcomesRandomized controlled trialSpironolactone

Identifiers

PMID26408016
OpenAlexW2149842736

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.