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Lessons from the TOPCAT Trial

2014; Massachusetts Medical Society; Volume: 370; Issue: 15 Linguagem: Inglês

10.1056/nejme1401231

1533-4406

John J.V. McMurray, Christopher M. O’Connor,

Cardiovascular Function and Risk Factors

Some patients with the clinical syndrome of heart failure have a normal or near-normal left ventricular ejection fraction.13 To date, no treatment has been shown to improve outcomes in this condition, usually designated heart failure with a preserved ejection fraction.2,3 The care of such patients can be difficult and is typically limited to efforts to relieve symptoms.Mineralocorticoid-receptor antagonists such as spironolactone are highly efficacious in patients with heart failure and a reduced ejection fraction.4,5 Pitt et al. now report in the Journal the findings of a trial comparing spironolactone with placebo in patients with heart failure . . .