Evidence map›Paper›PMID 42189342›Full record

ReviewHeart failure reviews2026

Mineralocorticoid receptor antagonists for the treatment of heart failure and kidney disease: a state-of-the-art review.

Harriette G C Van Spall, Orly Vardeny

Abstract readReview
In one paragraph

Review in Heart failure reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

2 authors.

Harriette G C Van SpallFaculty of Health Sciences, McMaster University, 20 Copeland Avenue, Suite C3-117, Hamilton, ON, L8S 4L8, Canada. Harriette.VanSpall@phri.ca.ORCID 0000-0002-8370-4569
Orly VardenyDepartment of Medicine, University of Minnesota, Minneapolis, MN, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic heart failure causes significant morbidity and mortality worldwide. Mineralocorticoid receptor antagonists are pivotal in the management of heart failure with reduced ejection fraction, as demonstrated in large outcomes trials that tested the efficacy of the steroidal mineralocorticoid receptor antagonists, spironolactone and eplerenone. There is still debate regarding their use in the management of heart failure with mildly reduced ejection fraction or heart failure with preserved ejection fraction. The nonsteroidal mineralocorticoid receptor antagonist finerenone was recently shown to improve outcomes in heart failure with mildly reduced ejection fraction and heart failure with preserved ejection fraction. This review of clinical trials evaluates the efficacy and safety of steroidal and nonsteroidal mineralocorticoid receptor antagonists for the treatment of heart failure across ejection fraction categories. We discuss the benefits of mineralocorticoid receptor antagonists in treating heart failure, including in the setting of chronic kidney disease, and review the benefits of nonsteroidal mineralocorticoid receptor antagonists in patients with chronic kidney disease who are at risk of developing heart failure. We outline the effect of mineralocorticoid receptor antagonists on serum potassium levels and propose strategies for minimizing the risk of hyperkalaemia. With a focus on clinical trial evidence, this review highlights that mineralocorticoid receptor antagonists have a favourable benefit-risk in the prevention and treatment of heart failure.

Indexed as

Heart FailureMineralocorticoid Receptor AntagonistsHumansHyperkalemiaNaphthyridinesSpironolactoneStroke VolumefinerenoneMineralocorticoid Receptor AntagonistsNaphthyridinesSpironolactoneBenefits and risksHeart failureHyperkalaemiaMineralocorticoid receptor antagonist

Identifiers

PMID42189342
PMCPMC13212694

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Registered trials

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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.