Searle's aldosterone antagonist Aldactone (spironolactone) has a firmplace in the treatment of heart failure when added to standard treatment regimens including ACE inhibitors, according to the results of RALES (Randomized Aldactone Evaluation Study). The data were presented at the American Heart Association meeting in Dallas by lead investigator Bertram Pitt, who is professor of the division of cardiology at the University of Michigan Medical School in the USA.
Prof Pitt reported that a reduction in total mortality in patients with severe heart failure was seen with spironolactone in the study, which involved 1,663 patients with NYHA class III or IV disease.
Trial Stopped Early The trial was stopped early because of the clear benefit seen with spironolactone. Among the patients randomized to treatment, there were 372 deaths (44%) in the placebo group and 283 deaths (34%) in the spironolactone group, corresponding to a 27% decrease in mortality. In addition, 91% of the placebo-treated and 81% of the spironolactone-treated patients had one or more non-fatal hospitalizations. Importantly, spironolactone was also well-tolerated when given in combination with ACE inhibition.
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