Evidence map›Paper›PMID 26991772›Full record

Trial reportClinical cardiology2016

Vascular Effects of Eplerenone in Coronary Artery Disease With Preserved Ejection Fraction: A Double-Blind, Randomized, Placebo-Controlled Trial.

Isabella Sudano, Matthias Naegele, Susanne Roas, Daniel Périat, Michelle Frank, Alexey Kouroedov, Georg Noll, Thomas F Lüscher, Frank Enseleit, Frank Ruschitzka and 1 more

Open access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Clinical cardiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 17% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
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

11 authors at 4 institutions in 1 country.

Isabella SudanoUniversity Heart Center, Cardiology Clinic, University Hospital Zurich, Zurich, Switzerland.
Matthias NaegeleUniversity Heart Center, Cardiology Clinic, University Hospital Zurich, Zurich, Switzerland.
Susanne RoasUniversity Heart Center, Cardiology Clinic, University Hospital Zurich, Zurich, Switzerland.
Daniel PériatUniversity Heart Center, Cardiology Clinic, University Hospital Zurich, Zurich, Switzerland.
Michelle FrankUniversity Heart Center, Cardiology Clinic, University Hospital Zurich, Zurich, Switzerland.
Alexey KouroedovCenter for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.
Georg NollUniversity Heart Center, Cardiology Clinic, University Hospital Zurich, Zurich, Switzerland.
Thomas F LüscherUniversity Heart Center, Cardiology Clinic, University Hospital Zurich, Zurich, Switzerland.
Frank EnseleitUniversity Heart Center, Cardiology Clinic, University Hospital Zurich, Zurich, Switzerland.
Frank RuschitzkaUniversity Heart Center, Cardiology Clinic, University Hospital Zurich, Zurich, Switzerland.
Andreas J FlammerUniversity Heart Center, Cardiology Clinic, University Hospital Zurich, Zurich, Switzerland.
University Hospital of Zurich · CHZurich Heart House · CHSwiss Integrative Center for Human Health · CHUniversity of Zurich · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMineralocorticoid receptor antagonists (MRAs) reduce morbidity and mortality in heart failure with reduced ejection fraction (HFrEF). Their role in patients without heart failure, particularly in patients with coronary artery disease (CAD) and preserved EF, is still a matter of debate. HYPOTHESIS: The MRA eplerenone on top of standard medical therapy improves endothelial dysfunction and other markers of vascular health in CAD patients with preserved EF.

methodsIn this double-blind, randomized, placebo-controlled study, 42 patients (mean age: 63.5 ± 9.1 years; 37 males) were randomized to 4-week treatment with eplerenone 25 mg daily or placebo. The primary endpoint was difference in endothelial function as assessed by flow-mediated dilatation (FMD) of the brachial artery. Secondary endpoints included 24-hour blood pressure (BP), endothelial progenitor cells, and platelet adhesion.

resultsNo difference in the primary endpoint FMD was noted after 4 weeks of treatment with eplerenone compared with placebo (FMD: 4.7% ± 2.0% and 4.9% ± 2.1%, respectively; P = 0.77). There were no significant differences between eplerenone and placebo in 24-hour BP (mean systolic BP: 126.9 ± 17.3 and 123.3 ± 9.7 mm Hg, P = 0.41; diastolic BP: 73.3 ± 12.9 and 72.0 ± 7.5 mm Hg, respectively, P = 0.69), number of endothelial progenitor cells, and platelet adhesion.

conclusionsAdding low-dose eplerenone to standard medical therapy did not improve important markers of vascular health in patients with CAD and preserved EF. Our results may help understand conflicting evidence from larger clinical trials on MRAs in patients with preserved EF.

Indexed as

Stroke VolumeVentricular Function, LeftAgedBlood PressureBrachial ArteryCoronary Artery DiseaseDouble-Blind MethodEndothelial Progenitor CellsEplerenoneFemaleHumansMaleMiddle AgedMineralocorticoid Receptor AntagonistsPlatelet AdhesivenessSpironolactoneEplerenoneMineralocorticoid Receptor AntagonistsSpironolactone

Identifiers

PMID26991772
PMCPMC6490773
OpenAlexW2300964931

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.