The effect of spironolactone on cardiovascular function and markers of fibrosis in people at increased risk of developing heart failure: The heart 'OMics' in AGEing (HOMAGE) randomized clinical trial
European Heart Journal, ISSN: 1522-9645, Vol: 42, Issue: 6, Page: 684-696
2021
- 97Citations
- 88Captures
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
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Metrics Details
- Citations97
- Citation Indexes97
- 97
- CrossRef63
- Captures88
- Readers88
- 88
Article Description
Aims: To investigate the effects of spironolactone on fibrosis and cardiac function in people at increased risk of developing heart failure. Methods and results: Randomized, open-label, blinded-endpoint trial comparing spironolactone (50 mg/day) or control for up to 9 months in people with, or at high risk of, coronary disease and raised plasma B-type natriuretic peptides. The primary endpoint was the interaction between baseline serum galectin-3 and changes in serum procollagen type-III N-terminal pro-peptide (PIIINP) in participants assigned to spironolactone or control. Procollagen type-I C-terminal pro-peptide (PICP) and collagen type-1 C-terminal telopeptide (CITP), reflecting synthesis and degradation of type-I collagen, were also measured. In 527 participants (median age 73 years, 26% women), changes in PIIINP were similar for spironolactone and control [mean difference (mdiff):-0.15; 95% confidence interval (CI)-0.44 to 0.15 μg/L; P = 0.32] but those receiving spironolactone had greater reductions in PICP (mdiff:-8.1; 95% CI-11.9 to-4.3 μg/L; P < 0.0001) and PICP/CITP ratio (mdiff:-2.9; 95% CI-4.3 to-1.5; <0.0001). No interactions with serum galectin were observed. Systolic blood pressure (mdiff:-10; 95% CI-13 to-7 mmHg; P < 0.0001), left atrial volume (mdiff:-1; 95% CI-2 to 0 mL/m2; P = 0.010), and NT-proBNP (mdiff:-57; 95% CI-81 to-33 ng/L; P < 0.0001) were reduced in those assigned spironolactone. Conclusion: Galectin-3 did not identify greater reductions in serum concentrations of collagen biomarkers in response to spironolactone. However, spironolactone may influence type-I collagen metabolism. Whether spironolactone can delay or prevent progression to symptomatic heart failure should be investigated.
Bibliographic Details
Oxford University Press (OUP)
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