Article Text

Download PDFPDF
Spironolactone reduced mortality in severe congestive heart failure

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

 QUESTION: In patients with severe congestive heart failure (CHF) caused by systolic left ventricular dysfunction, does spironolactone combined with usual care reduce all-cause mortality?


Randomised (allocation concealed*), blinded (patients, clinicians, and outcome assessors),* placebo-controlled trial with mean follow-up of 24 months. Interim analyses were done.


195 clinical centres in 15 countries.


1663 patients (mean age 65 y, 73% men, 87% white) with severe CHF who were using angiotensin-converting enzyme (ACE) inhibitors, if tolerated, and a loop diuretic and had had a recent left ventricular ejection fraction ≤35%. The major exclusion criterion was use of potassium-sparing diuretics. All patients were analysed.


All patients received usual care and were allocated to spironolactone, 25 mg/day, which could be doubled after 8 weeks …

View Full Text


  • Source of funding: Searle.

  • For correspondence: Dr B Pitt, Division of Cardiology, University of Michigan Medical Center, 3910 Taubman, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0366, USA. FAX 734-936-5256.

  • * See glossary.