Trial reportEuropean heart journal2021
The effect of spironolactone on cardiovascular function and markers of fibrosis in people at increased risk of developing heart failure: the heart 'OMics' in AGEing (HOMAGE) randomized clinical trial.
Trial report in European heart journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 2 of them syntheses that pooled it.
What it found
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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.
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
63 citing papers in PubMed, 2 syntheses or guidelines pooled it, 141 citations in OpenAlex.
- Incidence and progression of atrial fibrillation in patients with and without heart failure using mineralocorticoid receptor antagonists: a meta-analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Pooled it
- Spironolactone effect on cardiac structure and function of patients with heart failure and preserved ejection fraction: a pooled analysis of three randomized trials.European journal of heart failure · 2023Pooled it
- Trial
- Anaemia in patients with heart failure and mildly reduced or preserved ejection fraction: A prespecified analysis of the FINEARTS-HF trial.European journal of heart failure · 2025Trial
- Echocardiographic and biomarker characteristics in diabetes, coronary artery disease or both: insights from HOMAGE trial.Cardiovascular diabetology · 2025Trial
- Heart rate reactivity, recovery, and endurance of the incremental shuttle walk test in patients prone to heart failure.ESC heart failure · 2024Trial
- Effects of spironolactone on exercise blood pressure in patients at increased risk of developing heart failure: report from the HOMAGE trial.Hypertension research : official journal of the Japanese Society of Hypertension · 2024Trial
- Urinary proteomic signature of mineralocorticoid receptor antagonism by spironolactone: evidence from the HOMAGE trial.Heart (British Cardiac Society) · 2024Trial
- Effect on cardiac function among patients with type 2 diabetes following high-dose mineralocorticoid receptor antagonist using echocardiography; data from the MIRAD randomized clinical trial.BMC cardiovascular disorders · 2023Trial
- Proteomic Analysis of Effects of Spironolactone in Heart Failure With Preserved Ejection Fraction.Circulation. Heart failure · 2022Trial
- Weight changes in heart failure with preserved ejection fraction: findings from TOPCAT.Clinical research in cardiology : official journal of the German Cardiac Society · 2022Trial
- No influence of spironolactone on plasma concentrations of angiotensin-converting enzyme 2: Findings from the HOMAGE randomized trial.Archives of cardiovascular diseases · 2021Trial
- Trial
- Proteomic mechanistic profile of patients with diabetes at risk of developing heart failure: insights from the HOMAGE trial.Cardiovascular diabetology · 2021Trial
- Type 2 myocardial infarction and myocardial injury: eligibility for novel medical therapy to derisk clinical trials.Open heart · 2021Trial
- Targeting the aldosterone-mineralocorticoid receptor pathway in cardiovascular-kidney-metabolic syndrome.Nature reviews. Nephrology · 2026Review
- Cardiac fibrosis: mechanistic insights and translational advances.Molecular biomedicine · 2026Review
- Arrhythmic Mitral Valve Prolapse as a Regional Stretch-Induced Cardiomyopathy with Fibro-Inflammatory Signature: A Conceptual Review.Journal of cardiovascular development and disease · 2026Review
- Urinary proteomic signature of exercise intolerance in patients at risk of heart failure: evidence from the HOMAGE trial.EBioMedicine · 2026Article
- Mechanisms for Mineralocorticoid-Driven Age-Related Hypertension: Potential Therapeutic Role of Mineralocorticoid Receptor Antagonists and Aldosterone Synthase Inhibitors.Circulation research · 2026Review
3 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
31 authors at 15 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo investigate the effects of spironolactone on fibrosis and cardiac function in people at increased risk of developing heart failure. METHODS AND
resultsRandomized, open-label, blinded-endpoint trial comparing spironolactone (50 mg/day) or control for up to 9 months in people with, or at high risk of, coronary disease and raised plasma B-type natriuretic peptides. The primary endpoint was the interaction between baseline serum galectin-3 and changes in serum procollagen type-III N-terminal pro-peptide (PIIINP) in participants assigned to spironolactone or control. Procollagen type-I C-terminal pro-peptide (PICP) and collagen type-1 C-terminal telopeptide (CITP), reflecting synthesis and degradation of type-I collagen, were also measured. In 527 participants (median age 73 years, 26% women), changes in PIIINP were similar for spironolactone and control [mean difference (mdiff): -0.15; 95% confidence interval (CI) -0.44 to 0.15 μg/L; P = 0.32] but those receiving spironolactone had greater reductions in PICP (mdiff: -8.1; 95% CI -11.9 to -4.3 μg/L; P < 0.0001) and PICP/CITP ratio (mdiff: -2.9; 95% CI -4.3 to -1.5; <0.0001). No interactions with serum galectin were observed. Systolic blood pressure (mdiff: -10; 95% CI -13 to -7 mmHg; P < 0.0001), left atrial volume (mdiff: -1; 95% CI -2 to 0 mL/m2; P = 0.010), and NT-proBNP (mdiff: -57; 95% CI -81 to -33 ng/L; P < 0.0001) were reduced in those assigned spironolactone.
conclusionsGalectin-3 did not identify greater reductions in serum concentrations of collagen biomarkers in response to spironolactone. However, spironolactone may influence type-I collagen metabolism. Whether spironolactone can delay or prevent progression to symptomatic heart failure should be investigated.
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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.