SynthesisBMC cardiovascular disorders2025
Efficacy and safety of mineralocorticoid receptor antagonists in heart failure: a meta-analysis of randomized controlled trials.
Synthesis in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- Finerenone Across the Cardiovascular-Kidney-Metabolic Continuum: From Mechanistic Rationale to Clinical Positioning-A Narrative Review.Journal of clinical medicine · 2026Review
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMineralocorticoid receptor antagonists (MRAs) are established for heart failure with reduced ejection fraction (HFrEF), but their benefits in mildly reduced/preserved EF (HFmrEF/HFpEF) and agent-specific profiles require clarification. This meta-analysis aimed to evaluate the efficacy, safety, and benefit-risk profiles of MRAs across heart failure phenotypes and agents.
methodsThis meta-analysis synthesized data from randomized controlled trials (RCTs). The primary outcome was a composite of hospitalization for heart failure (HHF) or cardiovascular death. Secondary outcomes included HHF, cardiovascular/all-cause mortality, and safety endpoints. Subgroup analyses examined heart failure phenotypes and MRA agents. Benefit-risk was quantified via Number Needed to Treat/Harm (NNT/NNH).
resultsData from six RCTs (FINEARTS-HF, EPHESUS, EMPHASIS-HF, J-EMPHASIS-HF, TOPCAT, RALES; n = 20,699) were synthesized. MRAs significantly reduced the primary composite outcome (HR = 0.79, 95% CI 0.71-0.88; P < 0.001; NNT DISCUSSION: MRAs significantly reduce composite cardiovascular outcomes across heart failure phenotypes, with mortality benefits predominantly in HFrEF. Eplerenone appears to offer stronger mortality advantages, while spironolactone is more effective in reducing hospitalizations. These findings support phenotype- and agent-specific strategies to optimize the benefit-risk profile of MRA therapy in heart failure.
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