Chami T, et al. – This study investigated the incidence of atrial fibrillation (AF) subsequent to spironolactone treatment in patients with heart failure with reduced ejection fraction (HFrEF). Findings demonstrated that in this patient population, spironolactone was related to lower incidence of AF.

Methods

• Using an aggregated electronic database (Explorys Inc, Cleveland, OH), researchers conducted retrospective, matched cohort analysis on patients with active encounters between May 2012 and April 2017.
• Case group was defined as patients with HFrEF who were treated with spironolactone after their diagnosis.
• Control group was defined as patients with HFrEF who were never treated with spironolactone.
• 3-year cumulative incidence of AF was the primary outcome.

Results

• Researchers identified 68,990 patients in the case group and 89,644 age- and gender-matched controls.
• Findings demonstrated that three-year cumulative incidence of AF was significantly lower in the case group compared to controls (16.1% vs. 26.1%, relative risk (RR) 0.62 [95% CI: 0.61–0.63]).
• Data highlighted similar results in subgroup analysis for males (RR 0.60 [0.58–0.61]) and females (RR 0.66 [0.64–0.68]).
• Researchers obtained these findings despite the higher prevalence of cardiovascular comorbidities in the case group, including coronary artery disease [74.7% vs. 69.9%], obesity [38.9% vs. 33.3%], valvular disease [58.7% vs. 47.7%], and established conduction system disease [84.9% vs. 77.7%].