ArticleOpen heart2022
Motives, frequency, predictors and outcomes of MRA discontinuation in a real-world heart failure population.
Article in Open heart, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- The effect of down-titration and discontinuation of heart failure pharmacotherapy in older people: A systematic review and meta-analysis.British journal of clinical pharmacology · 2025Pooled it
- Review
- Aldosterone synthesis inhibitors in resistant hypertension: the BaxHTN trial.European heart journal supplements : journal of the European Society of Cardiology · 2026Article
- Comparative effectiveness of sodium zirconium cyclosilicate versus calcium polystyrene sulfonate for patients with heart failure.Heart and vessels · 2026Article
- Patterns of spironolactone management following hyperkalemia among hospitalized patients with heart failure and reduced ejection fraction: a retrospective single-center study.Frontiers in medicine · 2026Article
- Dose optimization and utilization trends of mineralocorticoid receptor antagonists in heart failure patients with reduced ejection fraction in Ethiopia.American heart journal plus : cardiology research and practice · 2025Article
- Deprescribing strategies in older patients with heart failure.Internal and emergency medicine · 2025Review
- Steroidal Mineralocorticoid Receptor Antagonist Side Effects and Reasons for Discontinuation: A Patient Survey (RELICS-PS).Pragmatic and observational research · 2025Article
- Treatment Patterns, Adverse Events, and Clinical Outcomes with Steroidal Mineralocorticoid Receptor Antagonists: A Retrospective Analysis of Administrative Claims Data (RELICS).Pragmatic and observational research · 2025Article
- Immunomodulation and immunopharmacology in heart failure.Nature reviews. Cardiology · 2024Review
- Multimorbidity in Heart Failure: Leveraging Cluster Analysis to Guide Tailored Treatment Strategies.Current heart failure reports · 2023Review
- Mineralocorticoid receptor antagonists for chronic heart failure: a meta-analysis focusing on the number needed to treat.Frontiers in cardiovascular medicine · 2023Review
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMineralocorticoid receptor antagonists (MRAs) reduce mortality and morbidity in patients with heart failure and reduced ejection fraction (HFrEF), but are largely underused. We evaluated the frequency, motives, predictors and outcomes of MRA discontinuation in a real-world heart failure population. METHODS AND
resultsThis was a single-centre, retrospective cohort study where medical record-based data were collected on patients with HFrEF between 2010 and 2018. In the final analysis, 572 patients were included that comprised the continued MRA group (n=275) and the discontinued MRA group (n=297). Patients that discontinued MRA were older, had a higher comorbidity index and a lower index estimated glomerular filtration rate (eGFR). Predictors of MRA discontinuations were increased S-potassium, lower eGFR, lower systolic blood pressure, higher frequency of comorbidities and a higher left ventricular ejection fraction. The most common reason for MRA discontinuation was renal dysfunction (n=97, 33%) with 59% of these having an eGFR <30 mL/min/1.73m
conclusionsHalf of all patients with HFrEF initiated on MRA discontinued the treatment. A substantial number of patients discontinued MRA without meeting the guideline-recommended levels of eGFR and S-potassium where mild to moderate hyperkalaemia seems to be the most decisive predictor. Further, MRA discontinuation was associated with increased adjusted risk of all-cause mortality.
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