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Emedinexus 18 February 2025
“Spironolactone did not reduce the incidence of death from cardiovascular causes, new or worsening heart failure, or a composite of these, in patients with myocardial infarction.
Mineralocorticoid receptor antagonists are known to lower mortality in patients who have had a myocardial infarction (heart attack) with congestive heart failure. However, it is unclear if routinely using spironolactone after a heart attack provides additional benefits.
A large trial studied 7,062 patients with heart attacks and heart failure. Of these, 3,537 were given spironolactone, while 3,525 received a placebo.
Researchers focused on two main outcomes: the total number of events involving death from cardiovascular causes or worsening heart failure, and the first occurrence of cardiovascular death, heart attack, stroke, or worsening heart failure.
The results showed that spironolactone did not significantly reduce the risk of these outcomes compared to the placebo. Additionally, serious side effects occurred in 7.2% of patients in the spironolactone group and 6.8% in the placebo group.
The study concluded that spironolactone does not lower the risk of cardiovascular death, worsening heart failure, or related complications when used routinely after a heart attack.
(Source:https://www.nejm.org/doi/full/10.1056/NEJMoa2405923)
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