Average dose at end of study was 25 mg. No significant difference was seen in death due to MI, stroke, other CV cause, or non-CV cause. No significant difference was seen in hospitalization due to angina, ventricular arrhythmia, MI, other CV cause, or non-CV cause. The latter two were not defined or quantified. No difference was seen in the subset of patients on or off beta-blockers.
Aldosterone causes myocardial and vascular fibrosis.
Blockade of this process could explain the cardio-protective benefits seen in the study. This is of little or no clinical significance. Bertram et al, The Effect of Spironolactone on Morbidity and Mortality in Patients with Severe Heart Failure. The study is to be published in nejm in September 2 nd , 1999.