SynthesisMedicine2018
Effects of spironolactone in heart failure with preserved ejection fraction: A meta-analysis of randomized controlled trials.
Synthesis in Medicine, 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.
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.
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.
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Effectiveness and safety of chronic diuretic use in older adults: an umbrella review of recently published systematic reviews and meta-analyses of randomized-controlled trials.European geriatric medicine · 2025Pooled it
- Beta-blockers and inhibitors of the renin-angiotensin aldosterone system for chronic heart failure with preserved ejection fraction.The Cochrane database of systematic reviews · 2021Pooled it
- Radiofrequency catheter ablation combined with spironolactone in the treatment of atrial fibrillation: A single-center randomized controlled study.Clinical cardiology · 2021Trial
- Heart failure and preserved ejection fraction: pathophysiology, clinical assessment, and management of exercise intolerance.European heart journal · 2026Review
- Review
- Mineralocorticoid Receptor Antagonists in Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- Spironolactone Reduces the Risk of Death in Veterans With Heart Failure With Preserved Ejection Fraction.Journal of the American Heart Association · 2024Article
- Advances in novel devices for the treatment of heart failure.Heart failure reviews · 2023Review
- Spironolactone Inhibits Cardiomyocyte Hypertrophy by Regulating the CaJournal of healthcare engineering · 2021Article
- Hyperkalemia and Acute Kidney Injury with Spironolactone Use Among Patients with Heart Failure.Mayo Clinic proceedings · 2020Article
- Narrative review of sleep and pulmonary hypertension.Journal of thoracic disease · 2020Review
- Spotlight on Spironolactone Oral Suspension for the Treatment of Heart Failure: Focus on Patient Selection and Perspectives.Vascular health and risk management · 2019Review
- Heart Failure Masked as Pulmonary Embolism in Non-adherent Patient With Atrial Fibrillation: Case Report and Analytical Review of the Literature.In vivo (Athens, Greece)Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHeart failure with preserved ejection fraction (HFpEF) is a common syndrome, accounting for more than one half of all heart failure patients, which is associated with high morbidity and mortality. But there is little evidence-based therapeutic strategies for the management of HFpEF. Previous studies reported the effects of spironolactone on HFpEF; however, the results were inconsistent. In this meta-analysis, we evaluated the effects of spironolactone on HFpEF.
methodsArticles were searched on PubMed, EMBASE, and COCHRANE databases before May, 2017, and were supplemented by hand searches of reference lists of included studies and review articles. Eligible articles were restricted to randomized controlled trials (RCTs). The odds ratios (ORs) of the dichotomous data, mean difference (MD) of continuous data, and 95% confidence intervals (CIs) were calculated to assess the effects of spironolactone in patients with HFpEF.
resultsA total of 7 studies including 4147 participants were analyzed. There were significant improvements on the E/e' index (MD -1.38; 95% CI, -2.03 to -0.73; P < .0001) and E/A velocity ratio (MD -0.05; 95% CI, -0.10 to -0.00; P = .03) under spironolactone treatment compared with placebo, while there was no effect on the deceleration time (MD 1.04; 95% CI, -8.27 to 10.35; P = .83). Subgroup analyses on the E/A velocity ratio showed that there was obvious benefit from spironolactone therapy in patients with follow-up periods >6 months but not in those with follow-up periods ≤6 months. There was no reduction in all-cause mortality and hospitalization compared with placebo. And no improvement in 6-minute walk distance was seen compared with placebo.
conclusionThis meta-analysis demonstrates that the use of spironolactone improves left ventricular diastolic function in patients with HFpEF, whereas it has no effect on all-cause mortality and hospitalization, and the 6-minute walk distance. Further larger size, multicenter, RCTs are required to confirm the effects of spironolactone on patients with HFpEF.
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Registered trials
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.