Evidence map›Paper›PMID 33529620›Full record

Trial reportThe American journal of cardiology2021

Effect of Obesity on Response to Spironolactone in Patients With Heart Failure With Preserved Ejection Fraction.

Khaled Elkholey, Lampros Papadimitriou, Javed Butler, Udho Thadani, Stavros Stavrakis

Open access · greenAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The American journal of cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed
3.8field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 45 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Weight changes in heart failure with preserved ejection fraction: findings from TOPCAT.Clinical research in cardiology : official journal of the German Cardiac Society · 2022
    Trial
  4. Trial
  5. Article
  6. Article
  7. Review
  8. Unmasking Hormonal Mechanisms of Hypertension in Obesity.JACC. Basic to translational science · 2026
    Article
  9. Article
  10. Review
  11. Unmasking Hormonal Mechanisms of Hypertension in Obesity.medRxiv : the preprint server for health sciences · 2025
    Article
  12. Review
  13. Review
  14. Review
  15. Article
  16. Review
  17. Article
  18. Review
  19. Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Khaled ElkholeyUniversity of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Lampros PapadimitriouUniversity of Mississippi Medical Center, Jackson, Mississippi.
Javed ButlerUniversity of Mississippi Medical Center, Jackson, Mississippi.
Udho ThadaniUniversity of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Stavros StavrakisUniversity of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. Electronic address: stavros-stavrakis@ouhsc.edu.
University of Oklahoma Health Sciences Center · USUniversity of Mississippi Medical Center · US

Funding

Addressing Health Disparities among Oklahoma Minority and Rural Communities through Clinical Research Education and Career DevelopmentR25MD011564 · NIMHD · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · PI HOUCHEN, COURTNEY WAYNE, STAVRAKIS, STAVROS · 2017 to 2021
$2.7M
Neuromodulation of Inflammation to Treat Heart Failure with Preserved Ejection FractionR21AG057879 · NIA · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · PI STAVRAKIS, STAVROS · 2018 to 2019
$407k
NIA NIH HHS R21 AG057879NIMHD NIH HHS R25 MD011564
6 · The paper itself

Abstract

Obesity is common in heart failure with preserved ejection fraction (HFpEF). Whether obesity modifies the response to spironolactone in patients with HFpEF remains unclear. We aimed to investigate the effect of obesity, defined by body mass index (BMI) and waist circumference (WC), on response to spironolactone in patients with HFpEF enrolled in Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist trial. This was a post-hoc, exploratory analysis of the Americas cohort of Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist trial. BMI≥30 kg/m2 was used to define the obese group and WC≥102 cm in men and ≥88 cm in women were defined as high WC. In separate analyses, BMI and WC were treated as continuous variables. The effect of spironolactone versus placebo on outcomes was calculated by BMI and WC using Cox proportional hazard models. Obese patients were younger and had more co-morbidities. In multivariate analysis, spironolactone use was associated with a significant reduction in the primary end point, compared with placebo in obese [hazard ratio (HR = 0.618, 95% CI 0.460 to 0.831, p = 0.001), but not in nonobese subjects (HR = 0.946, 95% CI 0.623 to 1.437, p = 0.796; p for interaction = 0.056). There was a linear association between continuous BMI and the effect of spironolactone, with the effect becoming significant at 33kg/m

Indexed as

AgedComorbidityDiureticsDouble-Blind MethodFemaleHeart FailureHumansMaleObesityPrevalencePrognosisProspective StudiesSpironolactoneStroke VolumeTreatment OutcomeUnited StatesDiureticsSpironolactone

Identifiers

PMID33529620
PMCPMC8038969
OpenAlexW3128072583

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.