Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Therapeutic value of spironolactone in wild-type transthyretin amyloid cardiomyopathy
Session:
Sessão de Posters 14 - Amiloidose Cardíaca
Speaker:
Luísa Pinheiro
Congress:
CPC 2024
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.4 Myocardial Disease – Treatment
Session Type:
Cartazes
FP Number:
---
Authors:
Luísa Pinheiro; Mariana Tinoco; Margarida Castro; Tamara Pereira; Olga Azevedo; António Lourenço
Abstract
<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>INTRODUCTION: </strong>Wild-type t<span style="background-color:white"><span style="color:black">ransthyretin amyloid cardiomyopathy (wtATTR-CM) is an increasingly recognized etiology of heart failure (HF). Recent evidence suggests spironolactone in wtATTR may be beneficial in patients with wtATTR-CM and preserved ejection fraction (EF).</span></span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>PURPOSE: </strong>To e<span style="background-color:white"><span style="color:black">valuate the therapeutic value of spironolactone in patients with wtATTR-CM.</span></span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Calibri",sans-serif">METHODS: </span></strong><span style="font-family:"Calibri",sans-serif">Retrospective, single-center study of </span><span style="background-color:white"><span style="color:black">patients with diagnosis of wtATTR-CM between 2014 and 2023. The primary endpoint was the composite endpoint of hospitalization due to HF or death from any cause. Spironolactone use and other clinical, laboratory, electrocardiographic and echocardiographic parameters at baseline were compared between patients who achieved vs. did not achieve the primary endpoint.</span></span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>RESULTS: </strong>A total of 90 patients were included in the study (72% male; mean age 81±5 years; baseline left ventricular ejection fraction (LVEF) 54% ± 14). Median follow-up was 21 [IQR 13-38] months. In this study, 28 (31%) patients were treated with <span style="background-color:white"><span style="color:black">spironolactone</span></span>, 14 <span style="background-color:white"><span style="color:black">achieved the primary endpoint</span></span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Patients who achieved vs. did not achieve the primary endpoint did not present significant differences at baseline regarding the use of<span style="background-color:white"><span style="color:black"> spironolactone,</span></span> gender, diabetes, conduction disturbances, and LVEF. More patients free of the primary endpoint used <span style="background-color:white"><span style="color:black">Sodium-Glucose Co-Transporter 2 Inhibitors (SGLT2i)</span></span> (75% vs. 37%; p<0.001), the same association was observed with renin-angiotensin-system-inhibitors (RASI) (70% vs. 34%; p<0.001), non-use of beta-blockers (64% vs. 42%; p=0.032), absence of atrial fibrillation (72% vs. 37%; p=0.001), levels of pro-B-type natriuretic peptide (proBNP) (7583<span style="color:black">±8675pg/mL</span> vs. 2549<span style="color:black">±2437pg/mL</span>; p=0.001), estimated glomerular filtration rate (eGFR) (69.7<span style="color:black">±25.6mL/min vs 57.1±22.7; p=0.016), interventricular septal thickness (</span>17.5<span style="color:black">±2.8</span>mm<span style="color:black"> vs 19.1±3.9; p=0.031), and left ventricular mass index (</span>160.4<span style="color:black">±40.8g/m<sup>2</sup> vs 185.7±50.9g/m<sup>2</sup>; p=0.013).</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Accordingly, survival analysis showed no difference in <span style="background-color:white"><span style="color:black">the primary endpoint</span></span> between the patients with vs. without spironolactone<span style="background-color:white"><span style="color:black">. Spironolactone use was also not associated with the isolated endpoints of total mortality or HF hospitalizations.</span></span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="background-color:white"><span style="color:black">A sub-analysis contemplating only patients with preserved ejection fraction (EF) at diagnosis (n=59), showed similar results, where </span></span>survival analysis demonstrated no difference in <span style="background-color:white"><span style="color:black">the primary endpoint</span></span> between the patients with vs. without spironolactone, or the <span style="background-color:white"><span style="color:black">isolated endpoints of total mortality or HF hospitalizations.</span></span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>CONCLUSIONS: </strong>Despite the limitations of the study, and contrary to recent studies, spironolactone use was not associated with improved outcomes, emphasizing the importance of future investigations to understand the true effect of mineralocorticoid receptor antagonists in wtATTR-CM patients.</span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site