Withdrawal of Spironolactone for Heart Failure With Improved Ejection Fraction: An Open-Label, Pilot, Randomized Controlled Trial (With-HF Trial).

ABSTRACT:

Background and objectives

The optimal strategy for the maintenance or discontinuation of evidence-based medication is unclear in heart failure (HF) patients with improved left ventricular ejection fraction (LVEF). We tested the feasibility and safety of withdrawing mineralocorticoid receptor antagonists (MRAs) in this population.

Methods

This is an open-label, prospective, randomized controlled pilot trial including HF patients whose LVEF improved from ≤35% to ≥50% after guideline-directed medical therapy. While testing withdrawal of MRA, other medications were maintained. The primary endpoint was the proportion of patients showing deteriorations in LVEF by ≥10% at 6-month follow-up. The secondary endpoints were numerical changes in echocardiographic parameters, changes in b

SUBMITTER: Hyun J 

PROVIDER: S-EPMC12705246 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature