Research highlights:
- The CLEAR SYNERGY trial found that spironolactone may reduce the risk of new or worsening heart failure. However, there was no significant effect on mortality, new heart attacks, or strokes.
- Further research is needed to further investigate the potential of spironolactone, a blood pressure drug, to prevent heart failure and its long-term effects on an individual’s heart health after a heart attack.
- Note: The research presented in this news release is a research summary. Abstracts presented at American Heart Association scientific meetings are not peer-reviewed, and research results are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.
Embargoed until Sunday, November 17, 2024, 8:55 a.m. CT/9:55 a.m. ET
This news release contains updated information from researchers not listed in the abstract.
CHICAGO, November 17, 2024 — A drug called spironolactone, often prescribed for hypertension (high blood pressure), may reduce the risk of heart failure in people recovering from a heart attack, a new study shows. It turns out. However, the number of deaths and other serious heart-related events did not decrease significantly, according to the latest science presented today at the American Heart Association. Academic Session 2024. The conference, to be held in Chicago from November 16 to 18, 2024, is the premier forum for the global exchange of the latest scientific advances, research, and evidence-based clinical practice updates in cardiovascular science. . The study will be published simultaneously today. New England Medical Journal.
The CLEAR SYNERGY (OASIS 9) trial involved more than 7,000 adults from 14 countries who experienced severe symptoms. heart attack. The focus of this study was to determine whether spironolactone is routinely used after a heart attack in patients with or without myocardial infarction. heart failure — May have broader benefits in reducing heart failure incidence and mortality. Spironolactone is a mineralocorticoid receptor antagonist that blocks certain hormones.
This study was a four-group, randomized, double-blind, placebo-controlled clinical trial (i.e., participants were randomly assigned to receive study treatment or sham/placebo treatment, and researchers also participated in (No one knew which group they belonged to). : Spironolactone and colchicine – anti-inflammatory drugs. spironolactone and placebo. colchicine and placebo. or two placebos.
The test results revealed the following:
- Overall mortality from heart-related problems was similar between the spironolactone and placebo groups (3.2% vs. 3.3%, respectively).
- Participants taking spironolactone (with or without colchicine) had a 31% lower risk of new or worsening heart failure than participants taking colchicine plus a placebo or two placebos (respectively). 1.6% vs. 2.4%).
- High potassium levels occurred twice as often in the spironolactone group compared to the placebo group (1.1% vs. 0.05%, respectively), resulting in more participants discontinuing drug use.
“Although spironolactone did not reduce death or other serious cardiac complications after a heart attack, it did reduce the likelihood of heart failure. This is an important finding for patients and health care professionals.” said Dr. Jolly, M.S. , the study’s lead author and a scientist at the Population Health Research Institute, a joint research institute of McMaster University and Hamilton Health Sciences in Hamilton, Ontario, Canada.
“In this trial, participants fared much better than in previous trials, which reflects advances in angioplasty technology across the treatment of heart attacks, including medications, stent technology, and more. Modern treatment approaches, such as timely intervention, are having a positive impact on patient outcomes.”
Research details, background and design:
- The study enrolled 7,062 participants from February 1, 2018 to November 8, 2022, with a median follow-up of 3 years.
- The average age of participants was 60 years, and 20% of participants identified as female.
- 95% had experienced a severe heart attack known as an ST-elevation myocardial infarction (STEMI).
- Approximately one in five (18%) had diabetes (type 1 or type 2).
The research group highlighted several important study limitations. Women and people of different races and ethnicities were underrepresented in the participant population, so results may not be generalizable to the larger population. Colchicine side effects may have influenced participants’ decision to discontinue spironolactone intake. This may partly explain the higher than expected proportion of people who discontinued spironolactone use (28%) and may have reduced the statistical power of the study.
Co-authors, disclosure information, and funding sources are listed in the manuscript.
Research statements and conclusions presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect the policy or position of the association. The Association makes no representations or warranties regarding its accuracy or reliability. Abstracts presented at the Society’s scientific conferences are not peer-reviewed, but are selected by an independent review committee and considered based on their potential to increase the diversity of scientific issues and views discussed at the conference. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.
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