Topcat profiles update#
Topcat profiles trial#

Topcat profiles trial#

The TOPCAT trial, a phase 3, international, double-blind, placebo-controlled trial of spironolactone in patients with HFpEF. Spironolactone for heart failure with preserved ejection fraction.

Pitt B, Pfeffer MA, Assmann SF, Boineau R, Anand IS, Claggett B, et al.

Effect of mineralocorticoid receptor antagonists on cardiac structure and function in patients with diastolic dysfunction and heart failure with preserved ejection fraction: a meta-analysis and systematic review. Pandey A, Garg S, Matulevicius SA, Shah AM, Garg J, Drazner MH, et al. Results of the randomized aldosterone antagonism in heart failure with preserved ejection fraction trial (RAAM-PEF). Effect of spironolactone on diastolic function and exercise capacity in patients with heart failure with preserved ejection fraction: the Aldo-DHF randomized controlled trial. The updated 2017 ACC/AHA/HFSA clinical practice guidelines for the management of patients with HF.Д®delmann F, Wachter R, Schmidt AG, Kraigher-Krainer E, Colantonio C, Kamke W, et al.

Topcat profiles update#

2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Colvin MM, et al.Serum aldosterone and its relationship to left ventricular structure and geometry in patients with preserved left ventricular ejection fraction.

doi: 10.1016/j.jacc.2013.11.053.Д®delmann F, Tomaschitz A, Wachter R, Gelbrich G, Knoke M, Dungen HD, et al. The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries. ДЄmbrosy AP, Fonarow GC, Butler J, Chioncel O, Greene SJ, Vaduganathan M, et al.Papers of particular interest, published recently, have been highlighted as: The overall design, execution, and study oversight of TOPCAT have provided key insights into the conduct of future HFpEF trials. A planned registry-based trial should provide additional evidence regarding the role of spironolactone in HFpEF. Given potential benefits in the Americas subgroup in TOPCAT, mineralocorticoid receptor antagonists can be considered in appropriately selected patients with HFpEF to reduce risk of heart failure hospitalization. Significant regional variation may impact the success of global HFpEF trials. Subsequent analyses of TOPCAT have revealed marked regional heterogeneity in patient profiles, event rates, drug adherence, and treatment effects. We identify key lessons from the TOPCAT experience that can be applied to future HFpEF trials. Spironolactone did not demonstrate benefit with respect to the primary composite endpoint in the global TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) trial in patients with chronic heart failure with preserved ejection fraction (HFpEF).