Aldosterone antagonists improve ejection fraction and functional capacity independently of functional class: A meta-analysis of randomised controlled trials

Abstract

Context: Current guidelines recommend the use of aldosterone antagonists (AA) in patients with moderately severe to severe symptoms [New York Heart Association (NYHA) class III to IV] and systolic heart failure. Objective: To determine the efficacy of AA in improving ejection fraction (EF) and functional capacity and to assess whether this effect was influenced by baseline NYHA classification. Study design: Meta-analysis of randomized controlled trials. Data extraction performed independently by two researchers. Data Sources: MEDLINE and the Cochrane Library. Study Selection: Prospective randomized controlled trials using AA were included if there was a clear description of the baseline NYHA..