A comparison of the effects of selective and non-selective mineralocorticoid antagonism on glucose homeostasis of heart failure patients with glucose intolerance or type II diabetes: A randomized controlled double-blind trial

Sandra Korol; Michel White; Eileen O'Meara; François Tournoux; Normand Racine; Anique Ducharme; Jean-Lucien Rouleau; Mark Liszkowski; Asmaa Mansour; Martin Jutras; Marie-Claude Guertin; Mathieu Bernier; Joël Lavoie; Grégoire Leclair; Paul-Eduard Neagoe; Diana Chaar; Martin G Sirois; Simon de Denus

doi:10.1016/j.ahj.2018.07.002

A comparison of the effects of selective and non-selective mineralocorticoid antagonism on glucose homeostasis of heart failure patients with glucose intolerance or type II diabetes: A randomized controlled double-blind trial

Am Heart J. 2018 Oct:204:190-195. doi: 10.1016/j.ahj.2018.07.002. Epub 2018 Jul 10.

Authors

Sandra Korol¹, Michel White², Eileen O'Meara³, François Tournoux⁴, Normand Racine³, Anique Ducharme³, Jean-Lucien Rouleau³, Mark Liszkowski³, Asmaa Mansour⁵, Martin Jutras⁶, Marie-Claude Guertin⁵, Mathieu Bernier⁷, Joël Lavoie⁸, Grégoire Leclair⁶, Paul-Eduard Neagoe⁸, Diana Chaar³, Martin G Sirois³, Simon de Denus⁹

Affiliations

¹ Montreal Heart Institute, Montreal, QC, Canada; Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada.
² Montreal Heart Institute, Montreal, QC, Canada; Faculty of Medicine, Université de Montréal, Montreal, QC, Canada. Electronic address: [email protected].
³ Montreal Heart Institute, Montreal, QC, Canada; Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
⁴ Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada.
⁵ Montreal Health Innovations Coordinating Center, Montreal, QC, Canada.
⁶ Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada.
⁷ Quebec Heart and Lung Institute, Quebec, QC, Canada.
⁸ Montreal Heart Institute, Montreal, QC, Canada.
⁹ Montreal Heart Institute, Montreal, QC, Canada; Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada. Electronic address: [email protected].

PMID: 30097164
DOI: 10.1016/j.ahj.2018.07.002

Abstract

Mineralocorticoid receptor antagonists (MRAs) decrease morbidity and mortality in patients with heart failure (HF). However, spironolactone, a non-selective MRA, has been shown to exert a harmful effect on glucose homeostasis. The objective of this multicenter, randomized, controlled, double-blind trial was to compare the effects of spironolactone to those of the selective MRA eplerenone on glucose homeostasis among 62 HF patients with glucose intolerance or type II diabetes. Trial registration number:NCT01586442.

Publication types

Comparative Study
Letter
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Biomarkers / blood
Biomarkers / urine
Blood Glucose / metabolism*
Diabetes Mellitus, Type 2 / complications*
Double-Blind Method
Eplerenone / adverse effects
Eplerenone / therapeutic use*
Female
Glucose Intolerance / complications*
Glycated Hemoglobin / metabolism
Heart Failure / blood*
Heart Failure / complications
Heart Failure / drug therapy*
Heart Failure / physiopathology
Homeostasis*
Humans
Insulin / blood
Insulin Resistance
Male
Middle Aged
Mineralocorticoid Receptor Antagonists / adverse effects
Mineralocorticoid Receptor Antagonists / therapeutic use*
Prospective Studies
Spironolactone / adverse effects
Spironolactone / therapeutic use*
Stroke Volume

Substances

Biomarkers
Blood Glucose
Glycated Hemoglobin A
Insulin
Mineralocorticoid Receptor Antagonists
hemoglobin A1c protein, human
Spironolactone
Eplerenone

Associated data

ClinicalTrials.gov/NCT01586442