Mineralocorticoid Receptor Antagonism by Eplerenone and Arterial Inflammation in HIV: The MIRABELLA HIV Study
Primary result · TBR of index vesselResult — go to the resultModel treatment effect −0.31 95% CI −0.50 to −0.11Authors' conclusion
In this small randomized clinical trial, eplerenone was associated with reduction in arterial inflammation among well-treated PWH without known CVD. In addition, reductions in arterial inflammation as measured by 18F-FDG PET/CT were related to improvements in stress myocardial perfusion.
Study context
- Population
- Well-treated persons with HIV without known cardiovascular disease (CVD) and no current statin use
- Participants
- 26 persons
- Comparison
- Eplerenone vs placebo
- Eplerenonen = 13
- Placebon = 13reference
- Primary endpoint
- Change in target to background ratio (TBR, arterial wall inflammation) in the index vessel (highest baseline TBR: aorta, left or right carotid) on 18F-FDG PET/CT
- Follow-up
- 12 months
Methodological detailsdouble-blind, placebo-controlled, substudy of MIRACLE HIV
- Double-blind
- Placebo-controlled
- Substudy of MIRACLE HIV
Primary result
TBR of index vessel
Model treatment effect
−0.31
95% CI −0.50 to −0.11
P = 0.006
By group
Eplerenone
−12.4%
percentage change · IQR −21.9%–-2.6%
Placebo
5.1%
percentage change · IQR −1.6%–11.0%
As reported in the abstract
Further findings
Percentage change
| Outcome | Eplerenone | Placebo | P value |
|---|---|---|---|
| TBR of most diseased segment (MDS) of index vessel | −19.1% (IQR −27.0%–-11.9%) | 6.8% (IQR −9.1%–12.1%) | P = 0.007 |
| TBR of carotid index vessel | −10.0% (IQR −21.8%–3.6%) | 9.7% (IQR −9.8%–15.9%) | P = 0.046 |
Correlation of most diseased segment (MDS) to background ratio (TBR) reduction with improvement in stress myocardial blood flow on CMR
- Spearman ρ
- −0.67; P = .01
Original publication
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