Heart failure & cardiomyopathies
Mineralocorticoid Receptor Antagonist Initiation During Admission is Associated with Improved Outcomes Irrespective of Ejection Fraction in Patients with Acute Heart Failure
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.
Summarised from the published abstract; every number is checked against it