Heart failure & cardiomyopathies
Initiation of eplerenone or spironolactone, treatment adherence, and associated outcomes in patients with new-onset heart failure with reduced ejection fraction: a nationwide cohort study
Authors' conclusion
In a contemporary nationwide cohort of patients with new-onset HFrEF who initiated MRA, we found no differences in clinical outcomes associated with initiation of eplerenone vs. spironolactone.
Study context
- Population
- Patients with new-onset heart failure with reduced ejection fraction (HFrEF), 2016–2020, alive and on MRA 180 days after HF diagnosis
- Participants
- 653 vs 6,840
- Exposure
- Eplerenone vs spironolactone
- Eplerenonen = 653
- Spironolactonen = 6,840reference
- Outcome
- Composite of:
- Death and HF hospitalization
- Each component
- Follow-up
- 2 years
Methodological detailsadjusted for age, sex and comorbidities
- Adjusted for age, sex and comorbidities
Main finding
As reported in the abstract
Eplerenone vs SpironolactoneHazard ratio (95% CI)
Composite of all-cause death and HF hospitalization
1.02(0.82–1.27)
All-cause death
0.93(0.67–1.30)
HF hospitalization
1.10(0.84–1.42)
Observational data: associations, not effects.
Further findings
Treatment withdrawal
P < 0.001
Treatment cross-over
Daily dose >25 mg · 12 months
P < 0.001
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Initiation of eplerenone or spironolactone, treatment adherence, and associated outcomes in patients with new-onset heart failure with reduced ejection fraction: a nationwide cohort study. Eur Heart J Cardiovasc Pharmacother. Published 24 June 2023. doi:10.
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