# Spironolacton en cardiovasculaire functie bij risico op HF: EHJ

*geplaatst 2021-02-11 · Hartfalen · European heart journal · doi 10.1093/eurheartj/ehaa758 · https://hartvaat.nl/2021/02/11/spironolacton-en-cardiovasculaire-functie-bij-risico-op-hf-ehj/*

Studie naar het effect van spironolacton op cardiovasculaire functie en fibrosemarkers bij personen met verhoogd HF-risico.

## English: 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.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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Bron: European heart journal, https://doi.org/10.1093/eurheartj/ehaa758. Bijgewerkt 2026-07-03T13:28:12Z. 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.