Population Health Research Institute

Spironolactone May Reduce Heart Failure Risk Post-Heart Attack

6 months ago

• A new study reveals spironolactone, a common hypertension medication, significantly reduces the risk of new or worsening heart failure in heart attack patients. • The CLEAR SYNERGY trial, involving over 7,000 adults, showed a 31% lower risk of heart failure in participants taking spironolactone compared to placebo. • While spironolactone reduced heart failure incidence, it did not significantly decrease the rate of death, new heart attack, or stroke. • The study highlights the potential of spironolactone in post-heart attack care, but also notes a higher incidence of high potassium levels, leading to medication discontinuation.

CLEAR SYNERGY Trial: Colchicine Fails to Show Benefit in Post-MI Patients

7 months ago

• The CLEAR SYNERGY trial (OASIS 9) found that colchicine did not reduce cardiovascular outcomes in patients following acute myocardial infarction (AMI). • The study revealed a notable side effect of diarrhea associated with colchicine use, impacting patient tolerability. • Experts suggest the findings may lead cardiologists to reconsider colchicine for post-MI treatment, especially given existing medication burdens. • Researchers emphasize the importance of continued investigation into post-MI inflammation, despite colchicine's lack of efficacy.

RAS Inhibitors: No Clear Advantage to Stopping or Continuing Before Noncardiac Surgery

9 months ago

• The Stop-or-Not trial found no significant difference in death or major complications at 28 days between continuing or discontinuing RAS inhibitors before noncardiac surgery. • Intra-operative hypotension was more frequent with continued RAS inhibitors, but did not translate to increased serious complications. • Experts suggest individualizing care based on patient factors, hemodynamics, and the specifics of the surgery, offering clinicians greater flexibility. • Current guidelines weakly suggest either strategy is reasonable, highlighting the need for more research, especially in heart failure patients.