What is RALES trial?

What is RALES trial?

RALES was a double-blind study which enrolled 1.663 patients with severe heart failure and a left ventricular ejection fraction of no more than 35 percent who were being treated with an angiotensin-converting-enzyme inhibitor, a loop diuretic and, in most cases, digoxin.

What is the RALES?

This is a fine, high-pitched crackling or rattling sound that can occur when you inhale. Rhonchi. This is a low-pitched sound that resembles snoring. Wheezing.

Does spironolactone improve ejection fraction?

Recent studies have shown the efficacy for using spironolactone to treat heart failure with reduced ejection fraction (HFrEF), but the efficacy of spironolactone for heart failure with mid-range ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF) is unclear.

How does spironolactone help the heart?

This medication is used to treat patients with heart failure when systolic dysfunction is present. Aldactone is usually prescribed to prevent heart failure symptoms from becoming worse. Aldactone protects the heart by blocking a certain chemical (aldosterone) in the body that causes salt and fluid build-up.

Does spironolactone have mortality benefit in heart failure?

One study3 has shown that spironolactone improves morbidity and mortality in patients with severe heart failure.

How are rales diagnosed?

A Profile on Lung Sounds Rhonchi and rales are types of lung sounds that can be heard with a stethoscope. Medical professionals listen to breathing sounds, a process called auscultation, in an effort to detect and aid in the diagnosis of potential lung disorders.

Can spironolactone worsen heart failure?

Treatment of heart failure with preserved ejection fraction (HFpEF) with spironolactone is associated with lower risk of heart failure hospitalization (HFH) but increased risk of worsening renal function (WRF). The prognostic implications of spironolactone-associated WRF in HFpEF patients are not well understood.

Is spironolactone for heart failure?

The familiar diuretic spironolactone has taken on new life as a treatment for left-sided congestive heart failure. Spironolactone has been shown to decrease mortality in such patients who are New York Heart Association class IV.

What are the major points of the RALES trial?

Major Points. RALES was the first of a series of trials to prospectively study aldosterone antagonists’ mortality benefits in HFrEF. Patients with NYHA class III-IV ischemic or nonischemic HF and EF <35% were randomized to spironolactone or placebo, with a majority of patients receiving a background of loop diuretics, ACE inhibitors, and digoxin.

What is the Arales study?

RALES was a double-blind study which enrolled 1.663 patients with severe heart failure and a left ventricular ejection fraction of no more than 35 percent who were being treated with an angiotensin-converting-enzyme inhibitor, a loop diuretic and, in most cases, digoxin.

How many patients were randomly assigned to a spironolactone trial?

A total of 822 patients were randomly assigned to receive 25 mg of spironolactone daily, and 841 to receive placebo. The primary end point was death from all causes. The trial was discontinued early, after a mean follow-up period of 24 months, because an interim analysis determined that spironolactone was efficacious.

Why did Rales use low-dose spironolactone?

That RALES used low-dose spironolactone suggests that its principal mechanism in prolonging survival has more to do with its effects on cardiac remodeling, and less with natriuresis. Aldosterone antagonists recommended after MI if LVEF ≤40% with HF symptoms or DM unless contraindicated (class I, level B)