The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators.

@article{Pitt1999TheEO,
  title={The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators.},
  author={B. Pitt and F. Zannad and W. Remme and R. Cody and A. Castaigne and A. Perez and J. Palensky and J. Wittes},
  journal={The New England journal of medicine},
  year={1999},
  volume={341 10},
  pages={
          709-17
        }
}
BACKGROUND AND METHODS Aldosterone is important in the pathophysiology of heart failure. In a doubleblind study, we enrolled 1663 patients who had severe heart failure and a left ventricular ejection fraction of no more than 35 percent and who were being treated with an angiotensin-converting-enzyme inhibitor, a loop diuretic, and in most cases digoxin. A total of 822 patients were randomly assigned to receive 25 mg of spironolactone daily, and 841 to receive placebo. The primary end point was… Expand
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Effects of Spironolactone on Long-term Mortality and Morbidity in Patients With Heart Failure and Mild or No Symptoms
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In patients with heart failure and a preserved ejection fraction, treatment with spironolactone did not significantly reduce the incidence of the primary composite outcome of death from cardiovascular causes, aborted cardiac arrest, or hospitalization for the management of heart failure. Expand
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The previously reported benefits of carvedilol with regard to morbidity and mortality in patients with mild-to-moderate heart failure were also apparent in the patients with severe heart failure who were evaluated in this trial. Expand
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For patients with HFPEF, the administration of spironolactone was associated with an increase in all-cause readmission, perhaps due to the higher rate of hyperpotassemia. Expand
Influence of Age on Efficacy and Safety of Spironolactone in Heart Failure.
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There were considerable effects of age on increased rates of adverse safety outcomes and these results should be weighed when considering spironolactone for older heart failure with preserved ejection fraction patients. Expand
Usefulness of spironolactone in a specialized heart failure clinic.
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Although the complication rate was higher, the benefits of spironolactone seen in RALES extended to participants not in a trial who were treated with similar doses and followed closely in a clinic specializing in heart failure. Expand
Effects of candesartan on mortality and morbidity in patients with chronic heart failure: the CHARM-Overall programme
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Codesartan was generally well tolerated and significantly reduced cardiovascular deaths and hospital admissions for heart failure and there was no significant heterogeneity for candesartan results across the component trials. Expand
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