Mineralocorticoid receptor antagonists for heart failure

Noemi Bruno; Gianfranco Sinagra; Stefania Paolillo; Alice Bonomi; Ugo Corrà; Massimo Piepoli; Fabrizio Veglia; Elisabetta Salvioni; Rocco Lagioia; Marco Metra; Giuseppe Limongelli; Gaia Cattadori; Angela B. Scardovi; Valentina Carubelli; Domenico Scrutino; Roberto Badagliacca; Marco Guazzi; Rosa Raimondo; Piero Gentile; Damiano Magrì; Michele Correale; Gianfranco Parati; Federica Re; Mariantonietta Cicoira; Maria Frigerio; Maurizio Bussotti; Carlo Vignati; Fabrizio Oliva; Alessandro Mezzani; Giuseppe Vergaro; Andrea Di Lenarda; Claudio Passino; Susanna Sciomer; Giuseppe Pacileo; Roberto Ricci; Mauro Contini; Anna Apostolo; Pietro Palermo; Massimo Mapelli; Cosimo Carriere; Francesco Clemenza; Simone Binno; Romualdo Belardinelli; Carlo Lombardi; Pasquale Perrone Filardi; Michele Emdin; Piergiuseppe Agostoni

doi:10.1002/ehf2.12244

Mineralocorticoid receptor antagonists for heart failure

Noemi Bruno, Gianfranco Sinagra, Stefania Paolillo, Alice Bonomi, Ugo Corrà, Massimo Piepoli, Fabrizio Veglia, Elisabetta Salvioni, Rocco Lagioia, Marco Metra, Giuseppe Limongelli, Gaia Cattadori, Angela B. Scardovi, Valentina Carubelli, Domenico Scrutino, Roberto Badagliacca, Marco Guazzi, Rosa Raimondo, Piero Gentile, Damiano MagrìMichele Correale, Gianfranco Parati, Federica Re, Mariantonietta Cicoira, Maria Frigerio, Maurizio Bussotti, Carlo Vignati, Fabrizio Oliva, Alessandro Mezzani, Giuseppe Vergaro, Andrea Di Lenarda, Claudio Passino, Susanna Sciomer, Giuseppe Pacileo, Roberto Ricci, Mauro Contini, Anna Apostolo, Pietro Palermo, Massimo Mapelli, Cosimo Carriere, Francesco Clemenza, Simone Binno, Romualdo Belardinelli, Carlo Lombardi, Pasquale Perrone Filardi, Michele Emdin, Piergiuseppe Agostoni

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Research output: Contribution to journal › Article › peer-review

Abstract

Aims: Mineralocorticoid receptor antagonists (MRAs) have been demonstrated to improve outcomes in reduced ejection fraction heart failure (HFrEF) patients. However, MRAs added to conventional treatment may lead to worsening of renal function and hyperkalaemia. We investigated, in a population-based analysis, the long-term effects of MRA treatment in HFrEF patients. Methods and results: We analysed data of 6046 patients included in the Metabolic Exercise Cardiac Kidney Index score dataset. Analysis was performed in patients treated (n = 3163) and not treated (n = 2883) with MRA. The study endpoint was a composite of cardiovascular death, urgent heart transplantation, or left ventricular assist device implantation. Ten years' survival was analysed through Kaplan–Meier, compared by log-rank test and propensity score matching. At 10 years' follow-up, the MRA-untreated group had a significantly lower number of events than the MRA-treated group (P

Original language	English
Pages (from-to)	267-274
Number of pages	8
Journal	ESC heart failure
Volume	5
Issue number	3
DOIs	https://doi.org/10.1002/ehf2.12244
Publication status	Published - Jan 1 2018

Keywords

Heart failure
Hyperkalaemia
Mineralocorticoid receptor antagonists
Worsening renal function

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10.1002/ehf2.12244

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Bruno, N., Sinagra, G., Paolillo, S., Bonomi, A., Corrà, U., Piepoli, M., Veglia, F., Salvioni, E., Lagioia, R., Metra, M., Limongelli, G., Cattadori, G., Scardovi, A. B., Carubelli, V., Scrutino, D., Badagliacca, R., Guazzi, M., Raimondo, R., Gentile, P., ... Agostoni, P. (2018). Mineralocorticoid receptor antagonists for heart failure. ESC heart failure, 5(3), 267-274. https://doi.org/10.1002/ehf2.12244

Mineralocorticoid receptor antagonists for heart failure. / Bruno, Noemi; Sinagra, Gianfranco; Paolillo, Stefania; Bonomi, Alice; Corrà, Ugo; Piepoli, Massimo; Veglia, Fabrizio; Salvioni, Elisabetta; Lagioia, Rocco; Metra, Marco; Limongelli, Giuseppe; Cattadori, Gaia; Scardovi, Angela B.; Carubelli, Valentina; Scrutino, Domenico; Badagliacca, Roberto; Guazzi, Marco; Raimondo, Rosa; Gentile, Piero; Magrì, Damiano; Correale, Michele; Parati, Gianfranco; Re, Federica; Cicoira, Mariantonietta; Frigerio, Maria; Bussotti, Maurizio; Vignati, Carlo; Oliva, Fabrizio; Mezzani, Alessandro; Vergaro, Giuseppe; Di Lenarda, Andrea; Passino, Claudio; Sciomer, Susanna; Pacileo, Giuseppe; Ricci, Roberto; Contini, Mauro; Apostolo, Anna; Palermo, Pietro; Mapelli, Massimo; Carriere, Cosimo; Clemenza, Francesco; Binno, Simone; Belardinelli, Romualdo; Lombardi, Carlo; Perrone Filardi, Pasquale; Emdin, Michele; Agostoni, Piergiuseppe.

In: ESC heart failure, Vol. 5, No. 3, 01.01.2018, p. 267-274.

Research output: Contribution to journal › Article › peer-review

Bruno, N, Sinagra, G, Paolillo, S, Bonomi, A, Corrà, U, Piepoli, M, Veglia, F, Salvioni, E, Lagioia, R, Metra, M, Limongelli, G, Cattadori, G, Scardovi, AB, Carubelli, V, Scrutino, D, Badagliacca, R, Guazzi, M, Raimondo, R, Gentile, P, Magrì, D, Correale, M, Parati, G, Re, F, Cicoira, M, Frigerio, M, Bussotti, M, Vignati, C, Oliva, F, Mezzani, A, Vergaro, G, Di Lenarda, A, Passino, C, Sciomer, S, Pacileo, G, Ricci, R, Contini, M, Apostolo, A, Palermo, P, Mapelli, M, Carriere, C, Clemenza, F, Binno, S, Belardinelli, R, Lombardi, C, Perrone Filardi, P, Emdin, M & Agostoni, P 2018, 'Mineralocorticoid receptor antagonists for heart failure', ESC heart failure, vol. 5, no. 3, pp. 267-274. https://doi.org/10.1002/ehf2.12244

Bruno, Noemi ; Sinagra, Gianfranco ; Paolillo, Stefania ; Bonomi, Alice ; Corrà, Ugo ; Piepoli, Massimo ; Veglia, Fabrizio ; Salvioni, Elisabetta ; Lagioia, Rocco ; Metra, Marco ; Limongelli, Giuseppe ; Cattadori, Gaia ; Scardovi, Angela B. ; Carubelli, Valentina ; Scrutino, Domenico ; Badagliacca, Roberto ; Guazzi, Marco ; Raimondo, Rosa ; Gentile, Piero ; Magrì, Damiano ; Correale, Michele ; Parati, Gianfranco ; Re, Federica ; Cicoira, Mariantonietta ; Frigerio, Maria ; Bussotti, Maurizio ; Vignati, Carlo ; Oliva, Fabrizio ; Mezzani, Alessandro ; Vergaro, Giuseppe ; Di Lenarda, Andrea ; Passino, Claudio ; Sciomer, Susanna ; Pacileo, Giuseppe ; Ricci, Roberto ; Contini, Mauro ; Apostolo, Anna ; Palermo, Pietro ; Mapelli, Massimo ; Carriere, Cosimo ; Clemenza, Francesco ; Binno, Simone ; Belardinelli, Romualdo ; Lombardi, Carlo ; Perrone Filardi, Pasquale ; Emdin, Michele ; Agostoni, Piergiuseppe. / Mineralocorticoid receptor antagonists for heart failure. In: ESC heart failure. 2018 ; Vol. 5, No. 3. pp. 267-274.

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abstract = "Aims: Mineralocorticoid receptor antagonists (MRAs) have been demonstrated to improve outcomes in reduced ejection fraction heart failure (HFrEF) patients. However, MRAs added to conventional treatment may lead to worsening of renal function and hyperkalaemia. We investigated, in a population-based analysis, the long-term effects of MRA treatment in HFrEF patients. Methods and results: We analysed data of 6046 patients included in the Metabolic Exercise Cardiac Kidney Index score dataset. Analysis was performed in patients treated (n = 3163) and not treated (n = 2883) with MRA. The study endpoint was a composite of cardiovascular death, urgent heart transplantation, or left ventricular assist device implantation. Ten years' survival was analysed through Kaplan–Meier, compared by log-rank test and propensity score matching. At 10 years' follow-up, the MRA-untreated group had a significantly lower number of events than the MRA-treated group (P ",

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AU - Paolillo, Stefania

AU - Bonomi, Alice

AU - Corrà, Ugo

AU - Piepoli, Massimo

AU - Veglia, Fabrizio

AU - Salvioni, Elisabetta

AU - Lagioia, Rocco

AU - Metra, Marco

AU - Limongelli, Giuseppe

AU - Cattadori, Gaia

AU - Scardovi, Angela B.

AU - Carubelli, Valentina

AU - Scrutino, Domenico

AU - Badagliacca, Roberto

AU - Guazzi, Marco

AU - Raimondo, Rosa

AU - Gentile, Piero

AU - Magrì, Damiano

AU - Correale, Michele

AU - Parati, Gianfranco

AU - Re, Federica

AU - Cicoira, Mariantonietta

AU - Frigerio, Maria

AU - Bussotti, Maurizio

AU - Vignati, Carlo

AU - Oliva, Fabrizio

AU - Mezzani, Alessandro

AU - Vergaro, Giuseppe

AU - Di Lenarda, Andrea

AU - Passino, Claudio

AU - Sciomer, Susanna

AU - Pacileo, Giuseppe

AU - Ricci, Roberto

AU - Contini, Mauro

AU - Apostolo, Anna

AU - Palermo, Pietro

AU - Mapelli, Massimo

AU - Carriere, Cosimo

AU - Clemenza, Francesco

AU - Binno, Simone

AU - Belardinelli, Romualdo

AU - Lombardi, Carlo

AU - Perrone Filardi, Pasquale

AU - Emdin, Michele

AU - Agostoni, Piergiuseppe

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N2 - Aims: Mineralocorticoid receptor antagonists (MRAs) have been demonstrated to improve outcomes in reduced ejection fraction heart failure (HFrEF) patients. However, MRAs added to conventional treatment may lead to worsening of renal function and hyperkalaemia. We investigated, in a population-based analysis, the long-term effects of MRA treatment in HFrEF patients. Methods and results: We analysed data of 6046 patients included in the Metabolic Exercise Cardiac Kidney Index score dataset. Analysis was performed in patients treated (n = 3163) and not treated (n = 2883) with MRA. The study endpoint was a composite of cardiovascular death, urgent heart transplantation, or left ventricular assist device implantation. Ten years' survival was analysed through Kaplan–Meier, compared by log-rank test and propensity score matching. At 10 years' follow-up, the MRA-untreated group had a significantly lower number of events than the MRA-treated group (P

AB - Aims: Mineralocorticoid receptor antagonists (MRAs) have been demonstrated to improve outcomes in reduced ejection fraction heart failure (HFrEF) patients. However, MRAs added to conventional treatment may lead to worsening of renal function and hyperkalaemia. We investigated, in a population-based analysis, the long-term effects of MRA treatment in HFrEF patients. Methods and results: We analysed data of 6046 patients included in the Metabolic Exercise Cardiac Kidney Index score dataset. Analysis was performed in patients treated (n = 3163) and not treated (n = 2883) with MRA. The study endpoint was a composite of cardiovascular death, urgent heart transplantation, or left ventricular assist device implantation. Ten years' survival was analysed through Kaplan–Meier, compared by log-rank test and propensity score matching. At 10 years' follow-up, the MRA-untreated group had a significantly lower number of events than the MRA-treated group (P

KW - Heart failure

KW - Hyperkalaemia

KW - Mineralocorticoid receptor antagonists

KW - Worsening renal function

U2 - 10.1002/ehf2.12244

DO - 10.1002/ehf2.12244

M3 - Article

VL - 5

SP - 267

EP - 274

JO - ESC heart failure

JF - ESC heart failure

SN - 2055-5822

IS - 3

ER -

Mineralocorticoid receptor antagonists for heart failure

Abstract

Keywords

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