Evidence map›Paper›PMID 34710128›Full record

Observational studyPloS one2021

Mineralocorticoid receptor antagonists use in patients with heart failure and impaired renal function.

Anna Jonsson Holmdahl, Helena Norberg, Fredrik Valham, Ellinor Bergdahl, Krister Lindmark

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.3field-weighted citation impact, top 39% 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

5 citing papers in PubMed, 5 citations in OpenAlex.

  1. Observational
  2. Article
  3. Article
  4. Review
  5. 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

5 authors at 1 institution in 1 country.

Anna Jonsson HolmdahlDepartment of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.ORCID 0000-0001-9319-0242
Helena NorbergDepartment of Integrative Medical Biology, Umeå University, Umeå, Sweden.ORCID 0000-0002-6785-2895
Fredrik ValhamDepartment of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Ellinor BergdahlDepartment of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Krister LindmarkDepartment of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Umeå University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsImpaired renal function is a major contributor to the low proportion of mineralocorticoid receptor antagonist (MRA) treatment in patients with heart failure with reduced ejection fraction (HFrEF). Our aims were to investigate the impact of MRA treatment on all-cause mortality and worsening renal function (WRF) in patients with HFrEF and moderately impaired renal function.

methodsRetrospective data between 2010-2018 on HFrEF patients from a single-centre hospital with estimated glomerular renal function (eGFR) < 60 ml/min/1.73 m2 were analysed. WRF was defined as a decline of by eGFR ≥ 20%.

results416 patients were included, 131 patients on MRA and 285 without MRA, mean age was 77 years (SD ± 9) and 82 years (SD ± 9), respectively. Median follow-up was 2 years. 128 patients (32%) experienced WRF, 25% in the MRA group and 30% in patients without MRA (p = 0.293). In multivariable analysis, hospitalization for heart failure and systolic blood pressure were associated with WRF (p = 0.015 and p = <0.001), but not use of MRA (p = 0.421). MRA treatment had no impact on the risk of adjusted all-cause mortality (HR 0.93; 95% CI, 0.66-1.32 p = 0.685). WRF was associated with increased adjusted risk of all-cause mortality (HR 1.43; 95% CI, 1.07-1.89 p = 0.014). Use of MRA did not increase the adjusted overall risk of mortality even when experiencing WRF (HR 1.15; 95% CI, 0.81-1.63 p = 0.422).

conclusionIn this cohort of elderly HFrEF patients with moderately impaired renal function, MRA did not increase risk for WRF or all-cause mortality.

Indexed as

AgedAged, 80 and overBlood PressureFemaleGlomerular Filtration RateHeart FailureHumansMaleMineralocorticoid Receptor AntagonistsRenal InsufficiencyRetrospective StudiesSurvival RateTreatment OutcomeMineralocorticoid Receptor Antagonists

Identifiers

PMID34710128
PMCPMC8553049
OpenAlexW3208018111

What OpenQuestion holds

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LicenceCC BY
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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.