Heart failure & cardiomyopathies
Previous heart failure hospitalization, spironolactone, and outcomes in heart failure with preserved ejection fraction – a secondary analysis of TOPCAT
Primary result · Composite of CV death or total HHFResult — go to the resultHazard ratio 1.26 95% CI 1.05–1.52Authors' conclusion
In TOPCAT-Americas, previous HHF was associated with CV death and first and total HHF. Duration since most recent HHF seemed to be associated with time to first HHF only. Spironolactone was associated with better outcomes in patients without a previous HHF.
Study context
- Population
- Patients with HFpEF in TOPCAT-Americas66% previous hospitalization for heart failure (HHF)
- Participants
- 1,765 patients
- Comparison
- Previous HHF vs no previous HHF; spironolactone effect by previous HHF
- Primary endpoint
- Composite of:
- CV death
- Total HHF
- Follow-up
- Median 2.9 years
Methodological detailsTOPCAT-Americas
- TOPCAT-Americas
Primary result
Composite of:
Hazard ratio
1.26
95% CI 1.05–1.52
P = 0.014
Previous HHFvs No previous HHF
HR 1.26 (95% CI 1.05–1.52); P = 0.014
As reported in the abstract
- Composite events of CV death or total HHF
- 1,064
Secondary outcomes
Spironolactone effect on composite outcome, by previous HHF (subgroup)
| HR (95% CI) | P value | ||
|---|---|---|---|
| SpironolactoneNo previous HHF | 0.63 (0.46–0.87) | P = 0.005 | |
| SpironolactonePrevious HHF | 0.91 (0.78–1.06) | P = 0.224 | |
| 0.512Hazard ratio (log scale) |
- Spironolactone effect on composite outcome, by previous HHF (subgroup): interaction-P .046
Time since most recent HHF
- Shorter time since most recent HHF appeared associated with subsequent first HHF, but not composite of CV death or total HHF
Original publication
Previous heart failure hospitalization, spironolactone, and outcomes in heart failure with preserved ejection fraction – a secondary analysis of TOPCAT. Am Heart J. Published 25 February 2024. doi:10.
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