Comparison of the Therapeutic Effects of Spironolactone at Doses of ۲۵ and ۵۰ mg in Patients with Systolic Heart Failure: A Randomized Clinical Trial

Background & Objective: Heart failure (HF), as the final stage of cardiovascular disease, is a prevalent cause of mortality, disability, and recurrent hospitalization. Effective treatment of systolic HF is crucial for reducing patient disability and preventing repeated hospital admissions. In this context, we aimed to conduct a comparative study of spironolactone at doses of ۲۵ mg and ۵۰ mg in patients with systolic HF. Materials & Methods: This randomized clinical trial was performed on ۱۰۰ patients with systolic HF. The patients were randomly divided into two treatment groups receiving ۲۵ and ۵۰ mg of spironolactone. Subsequently, changes in ejection fraction, frequency of hospitalization, performance capacity, quality of life, and electrolyte disorders were examined. Results: There was no significant difference between the groups in terms of age, sex, cardiovascular risk factors, history of cerebrovascular accidents, readmission rate, and EF changes (P>۰.۰۵). At the end of the study, the mean scores of performance capacity and quality of life in patients receiving ۵۰ mg of spironolactone were ۲۰۴.۳±۲۸ and ۳۲±۳.۱, respectively. These values were statistically higher than those reported in patients receiving ۲۵ mg of spironolactone (۱۷۸.۹±۳۰ and ۳۶.۷±۳.۳, respectively) (P<۰.۰۰۱). In patients who received ۵۰ mg of spironolactone, the average levels of potassium and blood urea nitrogen were ۰.۶۸±۰.۰۸ and ۶.۱±۱.۴, respectively. These levels were significantly higher compared to those in patients receiving a ۲۵mg dose, where the levels were ۰.۳۹±۰.۱۷ and ۴.۷±۲.۸, respectively (P<۰.۰۵). However, it is important to note that the maximum values observed did not exceed the normal range for these parameters. Conclusion: Compared to the ۲۵mg dose, the ۵۰mg dose of spironolactone was observed to enhance both the quality of life and performance capacity in patients with systolic HF. Therefore, it can be prescribed as the initial daily dosage for managing patients with HF.

کلیدواژه ها:

Heart Failure ، Spironolactone ، Readmission ، Quality of life