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Published on: April 8, 2013
Spironolactone use in patients with heart failure
J M Trujillo1, M J Gonyeau, M V DiVall
1Northeastern University School of Pharmacy, Northeastern University, Boston, MA 02115-5000, USA. j.trujillo@neu.edu
Journal of Clinical Pharmacy and Therapeutics
|April 8, 2004
Summary
Spironolactone, a heart failure medication, is underused in patients with severe symptoms. Despite evidence of its benefits, many eligible patients with class III or IV heart failure do not receive this crucial treatment.
Area of Science:
- Cardiology
- Pharmacology
- Internal Medicine
Background:
- Spironolactone, an aldosterone antagonist, is proven to reduce morbidity and mortality in severe heart failure.
- Standard therapy for heart failure can be enhanced by spironolactone.
Purpose of the Study:
- To assess the utilization of spironolactone in patients with class III and IV heart failure.
- To evaluate spironolactone prescribing patterns in four urban teaching hospitals.
Main Methods:
- A concurrent medical record review of 163 heart failure patients was performed.
- Data collected included demographics, heart failure class, ejection fraction, and medication use.
- Baseline status of patients was documented.
Main Results:
- 70% of patients had class III or IV heart failure.
- 57 patients met criteria for spironolactone use.
- Only 14% of ideal candidates (8 patients) were prescribed spironolactone.
Conclusions:
- Spironolactone remains underutilized in heart failure treatment, even years after key study publications.
- A significant proportion of patients with class III or IV heart failure are not prescribed spironolactone.
- Enhanced spironolactone prescribing practices are necessary.
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