Evidence mapPaperPMID 42167797Full record

ArticleOpen heart2026

Mineralocorticoid receptor antagonists in heart failure with sustained monomorphic ventricular tachycardia: comparative analysis of spironolactone versus eplerenone.

Imre Szakál, Ferenc Komlósi, Patrik Tóth, Bence Arnóth, Gyula Bohus, Péter Vámosi, Nándor Szegedi, Zoltán Salló, István Osztheimer, Péter Perge and 5 more

Abstract readComparative Study
In one paragraph

Article in Open heart, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

15 authors.

Imre Szakál *Semmelweis Egyetem Városmajori Szív- és Érgyógyászati Klinika, Budapest, Hungary.
Ferenc Komlósi *Semmelweis Egyetem Városmajori Szív- és Érgyógyászati Klinika, Budapest, Hungary.
Patrik TóthSemmelweis Egyetem Városmajori Szív- és Érgyógyászati Klinika, Budapest, Hungary.
Bence ArnóthSemmelweis Egyetem Városmajori Szív- és Érgyógyászati Klinika, Budapest, Hungary.
Gyula BohusSemmelweis Egyetem Városmajori Szív- és Érgyógyászati Klinika, Budapest, Hungary.
Péter VámosiSemmelweis Egyetem Városmajori Szív- és Érgyógyászati Klinika, Budapest, Hungary.
Nándor SzegediSemmelweis Egyetem Városmajori Szív- és Érgyógyászati Klinika, Budapest, Hungary.
Zoltán SallóSemmelweis Egyetem Városmajori Szív- és Érgyógyászati Klinika, Budapest, Hungary.
István OsztheimerSemmelweis Egyetem Városmajori Szív- és Érgyógyászati Klinika, Budapest, Hungary.
Péter PergeSemmelweis Egyetem Városmajori Szív- és Érgyógyászati Klinika, Budapest, Hungary.
Gábor OrbánSemmelweis Egyetem Városmajori Szív- és Érgyógyászati Klinika, Budapest, Hungary.ORCID http://orcid.org/0000-0002-5850-9892
Attila KardosGottsegen Gyorgy Orszagos Kardiovaszkularis Intezet, Budapest, Hungary.
Béla MerkelySemmelweis Egyetem Városmajori Szív- és Érgyógyászati Klinika, Budapest, Hungary.
László GellérSemmelweis Egyetem Városmajori Szív- és Érgyógyászati Klinika, Budapest, Hungary.
Klaudia Vivien NagySemmelweis Egyetem Városmajori Szív- és Érgyógyászati Klinika, Budapest, Hungary nagyklaudiavivien@gmail.com.ORCID http://orcid.org/0000-0001-6878-1892

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMineralocorticoid receptor antagonists (MRAs) are core therapy in chronic heart failure (HF) and reduce all-cause mortality and sudden cardiac death. However, direct comparisons of spironolactone and eplerenone in the context of ventricular arrhythmia recurrence are lacking. This study aims to compare the effects of these two MRAs on all-cause mortality and recurrence of sustained monomorphic ventricular tachycardia (VT) in patients with HF.

methodsWe analysed data of HF patients with left ventricular ejection fraction (LVEF) below 50%, hospitalised for sustained monomorphic VT and receiving MRA therapy at discharge. We performed propensity score matching for 13 variables, including medical history, medication and arrhythmia presentation. The endpoints were all-cause mortality and VT recurrence.

resultsAmong the 292 patients who met the selection criteria, 202 were included in the final analysis after propensity score matching, representing 69% of the eligible cohort. Median age was 67 (61-74) years and 87% were male. The median LVEF was 30% (25%-35%). The median follow-up duration was 32 (18-36) months, with a minimum follow-up of 1 year. During follow-up, 70 patients died, while VT recurrence was observed in 86 patients. There was no significant difference in all-cause mortality between the two MRAs (HR 0.98 (0.62 to 1.57), p=0.94). However, eplerenone was associated with a significantly lower risk of VT recurrence compared with spironolactone (HR 0.42 (0.26 to 0.66), p<0.001, Fine-Gray adjusted HR 0.36 (0.22 to 0.59), p<0.001).

conclusionsIn HF patients with sustained monomorphic VT, eplerenone was associated with fewer VT recurrences than spironolactone, without differences in all-cause mortality.

Indexed as

EplerenoneHeart FailureMineralocorticoid Receptor AntagonistsSpironolactoneTachycardia, VentricularAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedPropensity ScoreRecurrenceRetrospective StudiesRisk FactorsStroke VolumeEplerenoneMineralocorticoid Receptor AntagonistsSpironolactoneHeart FailurePharmacology, ClinicalTachycardia, Ventricular

Identifiers

PMID42167797
PMCPMC13202150

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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.