A drug often used to treat heart failure patients does little to lower cardiac arrest or death risk among people with a common form of the disease. But it does help reduce hospitalisations, a new study finds.
The study looked at heart failure patients whose hearts were still contracting normally or near normally. These patients account for about 40% of heart failure cases. Currently, there are no drugs to improve the prognoses of these patients, according to the study authors.
The researchers enrolled more than 3 400 patients in six countries who had heart failure with a "left ventricular ejection fraction" of 45% or more – which is considered normal or near normal contractions. Left ventricular ejection fraction is a measurement of how much blood is being pumped out of the heart's main pumping chamber with each contraction.
The patients were randomly assigned to receive 15 milligrams to 45 milligrams a day of spironolactone (Aldactone) or an inactive placebo, and were followed for an average of just over three years.
Eliminates excess fluid
Spironolactone is given to heart failure patients because it helps eliminate the excess fluid from the body that makes it hard for the heart to pump, and lowers blood pressure.
The study authors wanted to see how many patients were either hospitalised for heart failure, survived cardiac arrest, or suffered heart-related death – whichever occurred first. These events occurred in 18.6% of the patients who took spironolactone and in 20.4% of those in the placebo group.
When the outcomes were examined separately, those taking the drug did have a lower rate of hospitalization than those who took the placebo (12%versus 14.2%), according to the report published in the New England Journal of Medicine.
The study shows the potential effectiveness of spironolactone "in reducing the need for hospitalisations for heart failure in this population, as well as providing clues for more effectively designing future studies" to help reduce heart failure death rates, study co-senior author Dr Bertram Pitt, of the University of Michigan School of Medicine, said in a Brigham and Women's Hospital news release.
The study was funded by the US National Heart, Lung, and Blood Institute.