Mineralocorticoid receptor antagonists for acute myocardial infarction: a systematic review and meta-analysis of randomised controlled trials.

ABSTRACT:

Background

The role of mineralocorticoid receptor antagonists (MRAs) in acute myocardial infarction (MI) remains controversial, with conflicting evidence from landmark trials. We aimed to assess the impact of MRAs on mortality and cardiovascular outcomes post-acute MI.

Methods

We systematically searched PubMed, Embase and Cochrane CENTRAL databases up to February 2025 for randomised controlled trials comparing MRAs with placebo or standard care in adults experiencing acute MI. Primary outcome was all-cause mortality; secondary outcomes included cardiovascular mortality, heart failure, recurrent MI and ventricular arrhythmia. Data were pooled using random-effects models, with heterogeneity explored via subgroup analyses and meta-regression.

Results

15 trials (n=18 471)

SUBMITTER: Ang SP 

PROVIDER: S-EPMC12716514 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature