Sex Differences in Outcomes and Responses to Spironolactone in Heart Failure With Preserved Ejection Fraction: A Secondary Analysis of TOPCAT Trial

JACC. Heart Failure
Miranda MerrillDavid P Kao

Abstract

This study sought to investigate sex differences in outcomes and responses to spironolactone in patients with heart failure with preserved ejection fraction (HFpEF). HFpEF affects women more frequently than men. Sex differences in responses to effects of mineralocorticoid antagonists have not been reported. This was an exploratory, post hoc, non-pre-specified analysis of the TOPCAT (Aldosterone Antagonist Therapy for Adults With Heart Failure and Preserved Systolic Function) trial. Subjects with symptomatic HF and a left ventricular ejection fraction ≥45% were randomized to spironolactone or placebo therapy. Subjects enrolled from the Americas were analyzed. The primary outcome was a composite of cardiovascular (CV) death, cardiac arrest, or HF hospitalization. Secondary outcomes included all-cause mortality, CV, and non-CV mortality and CV, HF, and non-CV hospitalization. Sex differences in outcomes and treatment effects were determined using time-to-event analysis. In total, 882 of 1,767 subjects (49.9%) were women. Women were older with fewer comorbidities but worse patient-reported outcomes. There were no sex differences in outcomes in the placebo arm or in response to spironolactone for the primary outcome or its component...Continue Reading

Citations

Dec 10, 2019·Circulation. Heart Failure·Pooja DewanJohn J V McMurray
Feb 19, 2020·International Journal of Obesity : Journal of the International Association for the Study of Obesity·Camila Manrique-AcevedoDavid Gozal
Feb 16, 2020·Journal of Clinical Medicine·Gyu Chul OhHae-Young Lee
May 20, 2020·Journal of Women's Health·T Rajendra KumarJudith G Regensteiner
Jun 14, 2019·Frontiers in Physiology·Andreas B GevaertEmeline M Van Craenenbroeck
Jan 7, 2020·European Heart Journal·John G F ClelandJohn J V McMurray
Jun 7, 2019·Journal of Clinical Medicine·Marijana TadicMaurizio Galderisi
Feb 23, 2020·European Journal of Heart Failure·Xavier RosselloFaiez Zannad
Sep 12, 2019·Frontiers in Endocrinology·Stefania GoriniMassimiliano Caprio
May 5, 2020·Journal of Medical Education and Curricular Development·Helena SchluchterUte Seeland
Nov 6, 2020·European Journal of Heart Failure·Simon StewartUNKNOWN NEDA Investigators
Sep 2, 2019·Heart Failure Clinics·Jennifer Ballard-Hernandez, Dipti Itchhaporia
May 27, 2020·Current Opinion in Cardiology·Katherine E Di Palo
Jan 8, 2021·Frontiers in Cardiovascular Medicine·Andrea Postigo, Manuel Martínez-Sellés
Jan 1, 2021·The Canadian Journal of Cardiology·Kristen SullivanHarriette G C Van Spall
Mar 4, 2021·Pharmacological Reviews·Franck Mauvais-JarvisJoshua B Rubin
May 23, 2021·The Cochrane Database of Systematic Reviews·Nicole MartinR Thomas Lumbers
May 25, 2021·Frontiers in Cardiovascular Medicine·Marta FarreroBeatriz Díaz Molina
Jun 15, 2021·Frontiers in Molecular Biosciences·Yekatarina GadashevaClaudia Grossmann
May 17, 2021·Pharmacology & Therapeutics·Juan TamargoEva Delpón
Aug 31, 2021·Journal of the American Heart Association·Sudeep R AryalSteven G Lloyd
Jun 23, 2021·ESC Heart Failure·Anne RaafsStephane Heymans
Oct 14, 2021·British Journal of Pharmacology·Johann Bauersachs, Natalia López-Andrés
Nov 24, 2021·Journal of Molecular Medicine : Official Organ of the Gesellschaft Deutscher Naturforscher Und Ärzte·Cláudia FerreiraRita Nogueira-Ferreira

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