Baseline Characteristics of Patients in the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist Trial

Content Provider	Scilit
Author	O’Meara, Eileen Shah, Sanjiv J. Heitner, John F. Sweitzer, Nancy K. Anand, Inder S. Kim, Hae-Young Harty, Brian Boineau, Robin Clausell, Nadine Desai, Akshay S. Diaz, Rafael Fleg, Jerome L. Gordeev, Ivan Lewis, Eldrin F. Markov, Valetin Kobulia, Bondo Shaburishvili, Tamaz Solomon, Scott D. Pitt, Bertram Pfeffer, Marc A. Li, Rebecca
Copyright Year	2013
Description	Journal: Circulation: Heart Failure Background—: Treatment of Preserved Cardiac Function with an Aldosterone Antagonist (TOPCAT) is an ongoing randomized controlled trial of spironolactone versus placebo for heart failure with preserved ejection fraction (HFpEF). We sought to describe the baseline clinical characteristics of subjects enrolled in TOPCAT relative to other contemporary observational studies and randomized clinical trials of HFpEF. Methods and Results—: Between August 2006 and January 2012, 3445 patients with symptomatic HFpEF from 270 sites in 6 countries were enrolled in TOPCAT. At the baseline study visit, all subjects provided a detailed medical history and underwent physical examination, electrocardiography, quality of life, and laboratory assessment. Key parameters were compared with other large, contemporary HFpEF studies. The mean age was 68.6±9.6 years with a slight female predominance (52%); mean body mass index was 32 kg/m$ ^{2}$ ; and comorbidities were common. History of hypertension (91% prevalence in TOPCAT) exceeded all other major HFpEF clinical trials. However, baseline blood pressure was well controlled (129/76 mm Hg; systolic blood pressure 7–16 mm Hg lower than other similar trials). Other common comorbidities included coronary artery disease (57%), atrial fibrillation (35%), chronic kidney disease (38%) and diabetes mellitus (32%). Self-reported activity levels were low, quality of life scores were comparable with those reported for patients with end-stage renal disease, and the prevalence of moderate or greater depression was 27%. Conclusions—: TOPCAT subjects share many common characteristics with contemporary HFpEF cohorts. Low activity level, significantly decreased quality of life, and depression were common at baseline in TOPCAT, underscoring the continued unmet need for evidence-based treatment strategies in HFpEF. Clinical Trial Registration—: URL: http://www.clinicaltrials.gov . Unique identifier: NCT00094302.
Related Links	https://www.ahajournals.org/doi/pdf/10.1161/CIRCHEARTFAILURE.112.972794 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3605409/pdf https://www.ahajournals.org/doi/reader/10.1161/CIRCHEARTFAILURE.112.972794
Ending Page	192
Page Count	9
Starting Page	184
ISSN	19413289
e-ISSN	19413297
DOI	10.1161/circheartfailure.112.972794
Journal	Circulation: Heart Failure
Issue Number	2
Volume Number	6
Language	English
Publisher	Ovid Technologies (Wolters Kluwer Health)
Publisher Date	2013-03-01
Access Restriction	Open
Subject Keyword	Journal: Circulation: Heart Failure Peripheral Vascular Disease Mineralocorticoid Receptor Diastolic Heart Failure Randomized Controlled Trial
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine