Aim: To investigate a comparison of the aldosterone-blocking agents eplerenone and spironolactone on cardiovascular outcomes in patients with heart failure (HF). Methods: Among prospectively enrolled 838 patients who were hospitalized for acute decompensated HF, 90 patients treated with eplerenone were compared with propensity score matched 90 patients with spironolactone. The primary endpoint was a composite of cardiovascular death and hospitalization and secondary endpoint was all course mortality. Results: During follow up (594 ± 317 days), primary events were occurred in 27 patients in the eplerenone group (30.0%), 25 patients in the spironolactone group (27.8%). There were no significant differences for the primary endpoint (log-rank, P = .956) and secondary endpoint (log-rank, P = .814) among 2 groups. Conclusion: Among Japanese population with HF, eplerenone and spironolactone have similar impact on cardiovascular outcomes.
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