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
John G ClelandHOMAGE Trial Committees and Investigators

Abstract

To investigate the effects of spironolactone on fibrosis and cardiac function in people at increased risk of developing heart failure. 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), l...Continue Reading

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Citations

Feb 8, 2021·JACC. Heart Failure·James L Januzzi, Sean P Murphy
Feb 8, 2021·JACC. Heart Failure·João Pedro FerreiraUNKNOWN HOMAGE (Heart Omics in AGEing) Consortium
Apr 7, 2021·European Heart Journal. Cardiovascular Pharmacotherapy·João Pedro FerreiraFaiez Zannad
May 10, 2021·European Journal of Heart Failure·João Pedro Ferreira
May 24, 2021·JACC. Cardiovascular Imaging·Brian P Halliday
Aug 11, 2021·Cardiovascular Diabetology·Job A J VerdonschotUNKNOWN HOMAGE “Heart Omics in AGEing” consortium
Aug 14, 2021·Nature Medicine·John G F ClelandArantxa González
Oct 5, 2021·Frontiers in Cardiovascular Medicine·Yanjia ChenWei Jin
Nov 11, 2021·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·João Pedro FerreiraFaiez Zannad

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Methods Mentioned

BETA
enzyme-linked immunosorbent assay
biopsies

Clinical Trials Mentioned

NCT02556450

Software Mentioned

HOMAGE
SAS
Stata
Echo PAC
TOPCAT

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