ATHENA HF: High-Dose Spironolactone in Acute HF

Spironolactone in patients hospitalized for acute heart failure (HF) did not reduce NT-pro B-type natriuretic peptide levels more than usual care alone, according to the results of the ATHENA-HF Trial presented Nov. 16 during AHA 2016.

In the first randomized, double blind, placebo control, multi-center trial assessing the efficacy and safety of high dose mineral-corticoid receptor antagonist therapy in patients hospitalized with acute HF, Jayed Butler, MD, MPH, FACC, et al., randomized 360 patients (average age 65, 36 percent women, 42 percent black) to 100 mg daily spironolactone or placebo on top of usual care.

Researchers were not able replicate the findings from smaller studies, finding no difference in patients in the usual care arm (including loop diuretics) and in the interventional arm of usual care plus high dose mineral-corticoid receptor antagonists for four days. They found no difference in symptoms, physical examination, urine output, weight changes, clinical events, or in the primary endpoint of change in N-terminal pro-B-type natriuretic peptide levels from admission to 96 hours.

Clinical Topics: Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: AHA16, American Heart Association, AHA Annual Scientific Sessions, Acute Disease, Aldosterone, Heart Failure, Mineralocorticoid Receptor Antagonists, Natriuresis, Spironolactone, Standard of Care

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