Evidence mapPaperPMID 41065249Full record

ArticleJournal of the American Heart Association2025

Mineralocorticoid Receptor Antagonism Reduces Atrial Arrhythmias Post-Cardiac Surgery and Attenuates Atrial Stress Responses to Cardioplegic Arrest.

Sina Danesh, Fazal Khan, Trevor Chopko, Aurora Lee, Ran Huo, Shuyang Lu, Vincy Tam, Wenbin Gao, Austin Todd, Joseph J Maleszewski and 9 more

Abstract read
In one paragraph

Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
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

1 citing paper in PubMed.

  1. A 2025 Literature Review on Arrhythmias: Returning the Focus to Basic Science.The Journal of innovations in cardiac rhythm management · 2026
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors.

Sina DaneshDepartment of Cardiovascular Surgery Mayo Clinic Rochester MN USA.ORCID 0000-0002-4042-417X
Fazal KhanDepartment of Cardiovascular Surgery Mayo Clinic Rochester MN USA.ORCID 0000-0001-6687-1528
Trevor ChopkoDepartment of Surgery Mayo Clinic Rochester MN USA.ORCID 0009-0005-1036-3635
Aurora LeeDepartment of Cardiovascular Surgery Mayo Clinic Rochester MN USA.ORCID 0009-0000-4607-5188
Ran HuoDepartment of Cardiovascular Surgery Mayo Clinic Rochester MN USA.
Shuyang LuDepartment of Cardiovascular Surgery Mayo Clinic Rochester MN USA.
Vincy TamDepartment of Cardiovascular Surgery Mayo Clinic Rochester MN USA.ORCID 0009-0003-2967-0614
Wenbin GaoDepartment of Cardiovascular Surgery Mayo Clinic Rochester MN USA.ORCID 0000-0001-9268-8823
Austin ToddDepartment of Biomedical Statistics and Informatics and Department of Laboratory Medicine and Pathology Mayo Clinic Rochester MN USA.ORCID 0009-0003-7316-1411
Joseph J MaleszewskiDepartment of Laboratory Medicine and Pathology Mayo Clinic Rochester MN USA.ORCID 0000-0003-3239-6460
Francis D PaganiDepartment of Cardiac Surgery University of Michigan Frankel Cardiovascular Center Ann Arbor MN USA.ORCID 0000-0003-4430-9969
Hartzell SchaffDepartment of Cardiovascular Surgery Mayo Clinic Rochester MN USA.ORCID 0000-0003-0994-027X
Y Eugene ChenDepartment of Cardiac Surgery University of Michigan Frankel Cardiovascular Center Ann Arbor MN USA.ORCID 0000-0003-2357-7825
Paul A FriedmanDepartment of Cardiovascular Medicine Mayo Clinic Rochester MN USA.ORCID 0000-0001-5052-2948
Hakan OralDepartment of Internal Medicine, Division of Cardiovascular Medicine University of Michigan Frankel Cardiovascular Center Ann Arbor MN USA.ORCID 0000-0002-2237-0155
Marco MetraInstitute of Cardiology of the Civil Hospital, University of Brescia Italy.
Bertram PittDepartment of Internal Medicine, Division of Cardiovascular Medicine University of Michigan Frankel Cardiovascular Center Ann Arbor MN USA.ORCID 0000-0001-7703-0345
Ienglam LeiDepartment of Cardiovascular Surgery Mayo Clinic Rochester MN USA.
Paul C TangDepartment of Cardiovascular Surgery Mayo Clinic Rochester MN USA.ORCID 0000-0003-4211-8587

Funding

Targeting Mineralocorticoid Receptor Condensates to Optimize Donor Heart PreservationR01HL166140 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2023 to 2025
$1.4M
Targeting Immune-Responsive Gene 1 (Irg1) and Itaconate for Cardioprotection of the Donor Heart for TransplantationR01HL164416 · MAYO CLINIC ROCHESTER · 2025 to 2025
$648k
NHLBI NIH HHS R01 HL164416NHLBI NIH HHS R01 HL166140
6 · The paper itself

Abstract

backgroundPostoperative atrial fibrillation occurs in ~40% after cardiac surgery. Mineralocorticoid receptor antagonists (MRA) are known to reduce chronic atrial fibrillation (AF) development and burden. We evaluated the association of preoperative MRA use with postoperative atrial fibrillation and investigated atrial cell types modulated by MRAs during cold preservation.

methodsWe studied 19 042 cardiac surgery patients at Mayo Clinic. Propensity 1:3 matching identified 298 MRA users and 894 non-users. A subgroup analysis of patients on any preoperative diuretic was performed to isolate cardiac-specific effects of MRAs, matching 298 MRA users to 894 non-MRA diuretic users. AF recurrence was assessed for up to 6-years. Single-nucleus RNA sequencing (snRNA-seq) was performed on human donor atria exposed to canrenone (a water-soluble MRA) during cold preservation with ex-vivo reperfusion, and expression profiles were compared with atria from patients with AF.

resultsAfter matching, preoperative MRA use was associated with a lower incidence of postoperative atrial fibrillation (19.8% versus 31.8%,

conclusionsPreoperative MRAs were associated with reduced postoperative and long-term AF after cardiac surgery. Mechanistically, our ex-vivo human atrial model revealed that MRAs suppress mineralocorticoid receptor -driven atrial stress responses, particularly in conduction-relevant cardiomyocytes.

Indexed as

Atrial FibrillationCardiac Surgical ProceduresHeart AtriaMineralocorticoid Receptor AntagonistsPostoperative ComplicationsAgedFemaleHumansMaleMiddle AgedMyocytes, CardiacMineralocorticoid Receptor Antagonistsatrial fibrillationcanrenonecardiac preservationcardiac surgerymineralocorticoid receptor antagonistRNA sequencing

Identifiers

PMID41065249
PMCPMC12684550

What Socratic holds

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Registered trials

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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.