Heart failure & cardiomyopathies
Targeting Efficacy of Spironolactone in Patients with Heart Failure with Preserved Ejection Fraction: The TOPCAT Study
Authors' conclusion
Spironolactone treatment in HFpEF patients is feasible and effective in patients with high BMI and WBC while harmful in patients with low BMI and ALP.
Study context
- Population
- Patients with Heart failure with preserved ejection fraction (HFpEF) in the TOPCAT trial
- Participants
- 759 / 1,088 / 633 / 832
- Comparison
- Spironolactone across causal-forest-derived subgroups
- Group 1n = 759
- Group 2n = 1,088
- Group 3n = 633
- Group 4n = 832
- Primary endpoint
- CV death (HR of spironolactone by subgroup)
Methodological detailsmachine learning (causal forest), subgroup analysis
- Machine learning (causal forest)
- Subgroup analysis
Primary result
As reported in the abstract
CV death by subgroup
SpironolactoneHazard ratio (95% CI)P value
Group 4 (high BMI and WBC)
0.76(0.58–0.99)
P = 0.045Group 1 (low BMI and ALP)
1.45(1.02–2.07)
P = 0.041Further findings
- Similar risk of drug discontinuation across subgroups
- P for interaction = 0.498
Original publication
Targeting Efficacy of Spironolactone in Patients with Heart Failure with Preserved Ejection Fraction: The TOPCAT Study. ESC Heart Fail. Published 11 October 2022. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →