Heart failure & cardiomyopathiesSecondary analysis
Mineralocorticoid Receptor Antagonist Initiation During Admission is Associated with Improved Outcomes Irrespective of Ejection Fraction in Patients with Acute Heart Failure
- Secondary analysis of the RELAX-AHF-2 study
Authors' conclusion
In patients hospitalized for acute HF, in-hospital initiation of an MRA was associated with improved post-discharge outcomes, independent of left ventricular ejection fraction and other potential confounders.
Study context
- Population
- Patients hospitalized for acute heart failure (HF) enrolled in RELAX-AHF-2
- Participants
- 6,197 patients
- Comparison
- In-hospital MRA initiation vs no MRA
- In-hospital MRA initiationn = 1,690
- Continued MRAn = 1,438
- Discontinued MRAn = 418
- No MRAn = 2,651reference
- Primary endpoint
- Mortality, CV death, hospitalization for HF or renal failure, and composite of CV death and/or rehospitalization for HF or renal failure
- Follow-up
- 180 days
Primary result
As reported in the abstract
In-hospital initiation vs No MRAHazard ratio (95% CI)P value
mortality
0.76(0.60–0.96)
P = 0.02CV death
0.77(0.59–1.01)
P = 0.06hospitalization for HF or renal failure
0.72(0.60–0.86)
P = 0.0003CV death and/or rehospitalization for HF or renal failure
0.71(0.61–0.83)
P < 0.0001Further findings
MRA therapy use
- Baseline MRA therapy
- 30%
- MRA therapy at discharge
- 50%
Original publication
Mineralocorticoid Receptor Antagonist Initiation During Admission is Associated with Improved Outcomes Irrespective of Ejection Fraction in Patients with Acute Heart Failure. Eur J Heart Fail. Published 3 August 2023. doi:10.1002/ejhf.2975
Summarised from the published abstract; every number is checked against it