Association of Mineralocorticoid Receptor Antagonist Use With All-Cause Mortality and Hospital Readmission in Older Adults With Acute Decompensated Heart Failure

Use of MRA at discharge from ADHF  ( acute decompensated heart failure in HFrEF/HFpEF) hospitalization appeared to be associated with a lower risk of heart failure hospitalization but not with lower all-cause mortality or overall rate of hospitalization. No in this end- point was seen  benefit in 94% of patients with average age of 80 years old .

These findings suggest that MRA use might be associated with minimal, if any, clinical advantage. Further studies appear to be needed to identify the patient groups that may find value in MRA treatment and for findings to be confirmed by RCTs in patients hospitalized for ADHF.

This reminds me of the digoxin story in HF patients - high risk medication with essentially no benefit . Another med to de-escalate elderly patients often complicated HF medication list .