Observational studyClinical research in cardiology : official journal of the German Cardiac Society2018
Association of mineralocorticoid receptor antagonist use and in-hospital outcomes in patients with acute heart failure.
Observational study in Clinical research in cardiology : official journal of the German Cardiac Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- Availability of secondary healthcare data for conducting pharmacoepidemiology studies in Mexico: a systematic review.Journal of comparative effectiveness research · 2026Pooled it
- Impact of mineralocorticoid receptor antagonists on the risk of sudden cardiac death in patients with heart failure and left-ventricular systolic dysfunction: an individual patient-level meta-analysis of three randomized-controlled trials.Clinical research in cardiology : official journal of the German Cardiac Society · 2019Pooled it
- Decongestion Strategies in Acute Heart Failure.Current heart failure reports · 2026Review
- Acute Heart Failure: From The Emergency Department to the Intensive Care Unit.Cardiology clinics · 2024Review
- Contemporary Data on the Status and Medical Management of Acute Heart Failure.Current cardiology reports · 2022Review
- Angiotensin receptor-neprilysin inhibition in patients with acute decompensated heart failure: an expert consensus position paper.Heart failure reviews · 2022Review
- In-hospital Initiation and Up-titration of Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction.Cardiac failure review · 2022Review
- [Update on heart failure].Herz · 2020Review
- The role of the kidney in acute and chronic heart failure.Heart failure reviews · 2020Review
- Creation of a restrictive atrial communication in heart failure with preserved and mid-range ejection fraction: effective palliation of left atrial hypertension and pulmonary congestion.Clinical research in cardiology : official journal of the German Cardiac Society · 2018Article
- Mechanisms of cardiovascular complications in chronic kidney disease: research focus of the Transregional Research Consortium SFB TRR219 of the University Hospital Aachen (RWTH) and the Saarland University.Clinical research in cardiology : official journal of the German Cardiac Society · 2018Review
- Heart failure and the discrepancy between trials of intensive blood pressure management: an analysis of individual patient data.Clinical research in cardiology : official journal of the German Cardiac Society · 2018Article
- The clinical relevance of drug-drug interaction between co-trimoxazole and sacubitril/valsartan treatment in a heart failure patient: a case report and overview of mechanisms and management in clinical practice.Clinical research in cardiology : official journal of the German Cardiac Society · 2018Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Mineralocorticoid receptor antagonists (MRAs) constitute a beneficial therapy in chronic heart failure, but their use in the acute heart failure (AHF) setting remains rather unexplored. To assess the effect of MRAs administered during hospitalization on in-hospital outcomes of patients with AHF, we performed a post-hoc analysis of the Acute Heart Failure Global Registry of Standard Treatment (ALARM-HF). Patients of the original study cohort (n = 4953) were categorized according to in-hospital MRA treatment status as MRA-treated (n = 1439) and untreated (n = 3514) subjects. Nearest-neighbor propensity score with 1:1 matching yielded a subsample of pairs of MRA-treated and MRA-untreated patients (n = 1003 in each treatment group) that were balanced in an extensive list of baseline characteristics. In-hospital mortality between MRA-treated and untreated patients were assessed by Cox regression analysis before and after adjustment for known prognostic factors and other concomitantly administered intravenous and oral HF specific therapies. In the matched cohort, in-hospital mortality was 4.2 vs 10.8% in MRA-treated vs untreated patients. Treatment with MRAs was associated with a reduction of in-hospital mortality [HR 0.372 (95% CI, 0.261-0.532), p < 0.001]. This association remained significant after adjustment for known prognostic factors and co-administered intravenous and oral HF therapies [HR: 0.618 (95% CI, 0.383-0.995), p = 0.048]. In conclusion, MRA therapy administered during hospitalization for AHF was associated with reduced in-hospital mortality. The role of MRAs in AHF deserves further examination in adequately powered randomized controlled studies.
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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.