Research Activities January 2013, No. 389
Aldosterone antagonist therapy at hospital discharge linked to modest reduced risk of rehospitalization for heart failure
Patient Safety and Quality
Among older patients experiencing heart failure and reduced ejection fraction (reduced pumping ability), using aldosterone antagonist therapy at hospital discharge was not independently associated with improved mortality or cardiovascular readmission, according to new research from AHRQ's Effective Health Care Program. However, it was associated with a modest reduction in the risk of rehospitalization for heart failure.
Though aldosterone has been shown to be effective in clinical trials, it may have limited effectiveness in real-world settings among the most vulnerable patients because of lack of adherence to or persistence with medical therapy, or inconsistent monitoring based on guideline recommendations. Strict protocols for careful monitoring and early follow-up after initiation of aldosterone antagonist therapy are needed. Additional research is also needed to evaluate the clinical effectiveness of aldosterone antagonists in the broad population of patients with heart failure and to identify strategies to overcome disparities between findings of clinical efficacy and clinical effectiveness.
See "Associations Between Aldosterone Antagonist Therapy and Risks of Mortality and Readmission Among Patients With Heart Failure and Reduced Ejection Fraction" by Adrian F. Hernandez, MD, M.H.S., Xiaojuan Mi, PhD, Bradley G. Hammill, MS, and others in the November 2012 Journal of the American Medical Association 308(20), pp. 2097-2107.