Mineralocorticoid receptor antagonists in heart failure: a systematic review and meta-analysis.

ABSTRACT:

Background

Mineralocorticoid receptor over-activation drives maladaptive myocardial fibrosis, vascular inflammation and renal sodium retention across the entire spectrum of left ventricular ejection fraction (LVEF). While steroidal MRAs have convincingly reduced hospitalizations and mortality in patients with heart failure and reduced EF (HFrEF), evidence remains fragmented for heart failure with mildly reduced (HFmrEF) or preserved EF (HFpEF), and no head-to-head data distinguish steroidal from non-steroidal agents. This study aimed to evaluate the effect of MRAs in patients with HF across the range of ejection fraction.

Methods

Searched PubMed, Web of Science, Wanfang and Cochrane library (1 Jan 1987-10 Sep 2024) for randomized clinical trials (RCT) assessing MRAs (fineren

SUBMITTER: Zhang Y 

PROVIDER: S-EPMC12434096 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature