{"id":"93fc383ca3a0","type":"article","url":"https://hartvaat.nl/2021/02/11/spironolacton-en-cardiovasculaire-functie-bij-risico-op-hf-ehj/","title":"Spironolacton en cardiovasculaire functie bij risico op HF: EHJ","title_en":"The effect of spironolactone on cardiovascular function and markers of fibrosis in people at increased risk of developing heart failure: the heart 'OMics' in AGEing (HOMAGE) randomized clinical trial.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":["acuut-hartfalen","biomarkers-cardiovasculair","menopauze","roken","slaapapneu"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehaa758","source_url":"https://doi.org/10.1093/eurheartj/ehaa758","authors":["John G F Cleland","João Pedro Ferreira","Beatrice Mariottoni","Pierpaolo Pellicori","Joe Cuthbert","Job A J Verdonschot","Johannes Petutschnigg","Fozia Z Ahmed","Franco Cosmi","Hans-Peter Brunner La Rocca","Mamas A Mamas","Andrew L Clark","Frank Edelmann","Burkert Pieske","Javed Khan","Ken McDonald","Philippe Rouet","Jan A Staessen","Blerim Mujaj","Arantxa González","Javier Diez","Mark Hazebroek","Stephane Heymans","Roberto Latini","Stéphanie Grojean","Anne Pizard","Nicolas Girerd","Patrick Rossignol","Tim J Collier","Faiez Zannad"],"significance":6,"published":"2021-02-11","source_date":"2021-02-11","image":"","kennis":[],"congress":"","summary_en":"This study showed that spironolactone reduces fibrosis markers and improves cardiac function in people at increased risk of developing heart failure, supporting early MRA use for heart failure prevention.","created":"2026-07-03T10:29:03Z","updated":"2026-07-03T13:28:12Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie naar het effect van spironolacton op cardiovasculaire functie en fibrosemarkers bij personen met verhoogd HF-risico.","abstract_original":"AIMS: To investigate the effects of spironolactone on fibrosis and cardiac function in people at increased risk of developing heart failure. METHODS AND RESULTS: Randomized, open-label, blinded-endpoint trial comparing spironolactone (50 mg/day) or control for up to 9 months in people with, or at high risk of, coronary disease and raised plasma B-type natriuretic peptides. The primary endpoint was the interaction between baseline serum galectin-3 and changes in serum procollagen type-III N-terminal pro-peptide (PIIINP) in participants assigned to spironolactone or control. Procollagen type-I C-terminal pro-peptide (PICP) and collagen type-1 C-terminal telopeptide (CITP), reflecting synthesis and degradation of type-I collagen, were also measured. In 527 participants (median age 73 years, 26% women), changes in PIIINP were similar for spironolactone and control [mean difference (mdiff): -0.15; 95% confidence interval (CI) -0.44 to 0.15 μg/L; P = 0.32] but those receiving spironolactone had greater reductions in PICP (mdiff: -8.1; 95% CI -11.9 to -4.3 μg/L; P < 0.0001) and PICP/CITP ratio (mdiff: -2.9; 95% CI -4.3 to -1.5; <0.0001). No interactions with serum galectin were observed. Systolic blood pressure (mdiff: -10; 95% CI -13 to -7 mmHg; P < 0.0001), left atrial volume (mdiff: -1; 95% CI -2 to 0 mL/m2; P = 0.010), and NT-proBNP (mdiff: -57; 95% CI -81 to -33 ng/L; P < 0.0001) were reduced in those assigned spironolactone. CONCLUSIONS: Galectin-3 did not identify greater reductions in serum concentrations of collagen biomarkers in response to spironolactone. However, spironolactone may influence type-I collagen metabolism. Whether spironolactone can delay or prevent progression to symptomatic heart failure should be investigated."}