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A Registry-based Cluster Randomized Trial to Compare the Effect of Spironolactone vs. Eplerenone on Clinical Outcomes in Patients With Symptomatic Systolic Heart Failure

Phase 4
Conditions
Systolic Heart Failure
Interventions
Registration Number
NCT03984591
Lead Sponsor
Bispebjerg Hospital
Brief Summary

Objective The objective is to compare the efficacy of spironolactone and eplerenone on clinical outcome in patients with heart failure and a reduced ejection fraction.

Method The study is a crossover cluster randomized trial. Each heart failure clinic in Denmark will be allocated to four periods (clusters): two periods with spironolactone and two periods with eplerenone as first drug. The planned total participation time for each department is 4 years and we estimate that data from 7200 patients will be accrued in this period. Endpoints will be assessed through Danish National Registries.

Detailed Description

Not available

Recruitment & Eligibility

Status
ENROLLING_BY_INVITATION
Sex
All
Target Recruitment
7200
Inclusion Criteria
  • all patients registered in the Danish Heart Failure Registry who has a baseline left ventricular ejection fraction <40% and who has filled in a prescription for an aldosterone antagonist
Exclusion Criteria
  • patients who had filled in a prescription for an aldosterone antagonist prior ro registration in the Danish Heart Failure Registry

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
SpironolactoneSpironolactoneSpironolactone used according to heart failure guidelines
EplerenoneEplerenoneEplerenone used according to heart failure guidelines
Primary Outcome Measures
NameTimeMethod
Mortality5 years

Mortality (will be used if overall mortality rate is 15% or greater)

Mortality or hospitalization for heart failure6 years

Will be used if overall mortality is less than 15%

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Bispebjerg Hospital

🇩🇰

Copenhagen, Denmark

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