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A recent large-scale clinical trial has found that incorporating spironolactone into the treatment regimen for acute myocardial infarction (heart attack) does not provide significant benefits in reducing mortality or worsening heart failure.
Study Overview Mineralocorticoid receptor antagonists, such as spironolactone, have been known to lower mortality in patients experiencing heart attacks with congestive heart failure. However, the routine use of spironolactone following a heart attack remained a subject of investigation.
To assess its effectiveness, researchers conducted a large-scale trial involving 7,062 patients who had suffered a heart attack and were experiencing heart failure. Among them, 3,537 were administered spironolactone, while 3,525 received a placebo.
Key Findings The study analyzed two primary outcomes:
- The total number of events involving death from cardiovascular causes or worsening heart failure.
- The first occurrence of cardiovascular death, heart attack, stroke, or worsening heart failure.
The results revealed that spironolactone did not significantly lower the risk of these adverse outcomes compared to the placebo group. Moreover, serious side effects were observed in 7.2% of patients receiving spironolactone, compared to 6.8% in the placebo group.
Conclusion Based on the findings, researchers concluded that routine use of spironolactone following a heart attack does not reduce the risk of cardiovascular death, worsening heart failure, or related complications.
Disclaimer: This article is based on a study published in The New England Journal of Medicine. It is intended for informational purposes only and should not be considered medical advice. Patients should consult their healthcare providers before making any changes to their treatment regimen.
(Source: https://www.nejm.org/doi/full/10.1056/NEJMoa2405923)
