Spironolactone is associated with reduced risk of new-onset atrial fibrillation in patients receiving renal replacement therapy

Chung, Yi Wei; Wu, Cho Kai; Yu, Chih Chieh; Juang, Jyh-Ming Jimmy; Wang, Yi Chih; Tsai, Chia Ti; Lin, Lian Yu; Lai, Ling‐Ping; Hwang, Juey Jen; Chiang, Fu-Tien; Chen, Pau‐Chung; Lin, Jiunn Lee

doi:10.1016/j.ijcard.2015.05.167

Cited by 14 publications

(10 citation statements)

References 31 publications

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“…3) [15,16,26]. The study of Chung et al included only patients with end-stage renal failure [16]. However, the results of this study did not change the conclusion and exclusion of the study from the analysis yielded a similar significant reduction of AF risk in MRA treated patients (OR: 0.57 CI 95%: 0.38-0.84, p = 0.005).…”

Section: New-onset Atrial Fibrillationmentioning

confidence: 87%

“…The low incidence of AF, as in the study cohort of Chung et al and Swedberg et al, could have underestimated the effects of MRA [16,26]. However, this would only strengthen the reported effects.…”

Section: Limitationsmentioning

confidence: 94%

“…The number of patients ranged between 74 and 1794 patients per study cohort, with 5332 patients in total [15][16][17][18][19][20][21][22][23][24][25][26][27]. All study cohorts included both patients with paroxysmal or persistent AF, except for the study cohorts of Ito et al and Kim et al, who only included patients with persistent AF (n = 161 respectively n = 74 patients) [19,20].…”

Section: Study Populationmentioning

confidence: 99%

“…(Fig. 3) [15,16,26]. The study of Chung et al included only patients with end-stage renal failure [16].…”

Section: New-onset Atrial Fibrillationmentioning

confidence: 99%

See 3 more Smart Citations

Aldosterone Pathway Blockade to Prevent Atrial Fibrillation: A Systematic Review and Meta-Analysis

Neefs

Berg

Limpens

et al. 2017

International Journal of Cardiology

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Section: New-onset Atrial Fibrillationmentioning

confidence: 87%

Section: Limitationsmentioning

confidence: 94%

Section: Study Populationmentioning

confidence: 99%

“…(Fig. 3) [15,16,26]. The study of Chung et al included only patients with end-stage renal failure [16].…”

Section: New-onset Atrial Fibrillationmentioning

confidence: 99%

See 2 more Smart Citations

Aldosterone Pathway Blockade to Prevent Atrial Fibrillation: A Systematic Review and Meta-Analysis

Neefs

Berg

Limpens

et al. 2017

International Journal of Cardiology

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“…20 30 31 Increasing clinical studies have shown that MRAs reduce the incidence of cardiovascular events and all-cause mortality in patients with chronic kidney disease or heart failure. [32][33][34][35] However, the antihypertensive efficacy and safety of MRAs in patients with hypertension and GDM have not been demonstrated in large clinical trials, and it is unclear whether the MRAs bring an extra cardiovascular benefit for patients with hypertension and GDM and low potassium.…”

mentioning

confidence: 99%

Effect of spironolactone on cardiovascular morbidity and mortality in patients with hypertension and glucose metabolism disorders (ESCAM): a study protocol for a pragmatic randomised controlled trial

Lin

Heizhati

et al. 2020

BMJ Open

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IntroductionHypertension combined with diabetes and hypokalemia is more likely to develop hyperaldosteronism and is at higher risk of cardiovascular events. There is evidence that activation of aldosterone and mineralocorticoid receptors may play a significant role in the occurrence of cardiovascular events in patients with hypertension and diabetes. Clinical studies have demonstrated that spironolactone can reduce the incidence of cardiovascular events in patients with chronic kidney diseases or severe heart failure. However, the effect of spironolactone on cardiovascular risk in patients with hypertension and glucose metabolism disorders (GMD) and low potassium has been scarcely studied. Therefore, this study aims to evaluate whether add-on spironolactone (conventional antihypertensive drugs alone vs conventional antihypertensive drugs+spironolactone) can reduce the morbidity and mortality of cardiovascular events in this population.Methods and analysisIn this multicentre, randomised, parallel-controlled study, a total of 7140 hypertensive patients aged 45–75 years with GMD and low potassium will be randomised in a 1:1 manner to the control or the spironolactone group (20 mg/day or with a maximum dose of 40 mg). The primary objective is to estimate the difference in the HR of composite cardiovascular events between the two groups. We will also assess the effects of spironolactone on individual cardiovascular events and the progression of diabetes and renal dysfunction.Ethics and disseminationThis protocol was approved by the Independent Ethics Committee of People’s Hospital of Xinjiang Uygur Autonomous Region (no. 2020020618). The results will be disseminated in peer-reviewed journals and at scientific conferences.Trial registration numberChiCTR2000028909.

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Effects of mineralocorticoid receptor antagonists on left ventricular mass in chronic kidney disease patients: a systematic review and meta-analysis

Zhang

Zhu

et al. 2016

Int Urol Nephrol

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Spironolactone is associated with reduced risk of new-onset atrial fibrillation in patients receiving renal replacement therapy

Cited by 14 publications

References 31 publications

Aldosterone Pathway Blockade to Prevent Atrial Fibrillation: A Systematic Review and Meta-Analysis

Aldosterone Pathway Blockade to Prevent Atrial Fibrillation: A Systematic Review and Meta-Analysis

Effect of spironolactone on cardiovascular morbidity and mortality in patients with hypertension and glucose metabolism disorders (ESCAM): a study protocol for a pragmatic randomised controlled trial

Effects of mineralocorticoid receptor antagonists on left ventricular mass in chronic kidney disease patients: a systematic review and meta-analysis

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