Heart failure — Mineralocorticoid receptor (spironolactone)

Treating predominantly central sleep apnea with adaptive servo-ventilation would improve outcomes in heart failure with reduced ejection fraction.

In 1,325 patients the primary endpoint did not differ (54.1% vs 50.8%, HR 1.13, P=0.10), and all-cause mortality was significantly higher with servo-ventilation (HR 1.28, P=0.01), as was cardiovascular death (HR 1.34, P=0.006).

Why it matched: similar wording · same research area

Clearing the parasite with benznidazole in patients with established Chagas cardiomyopathy would slow cardiac clinical deterioration.

Among 2,854 patients followed a mean 5.4 years, the composite cardiac outcome occurred in 27.5% vs 29.1% on placebo (HR 0.93, P=0.31).

Why it matched: similar wording · same research area

Adding fenofibrate to statin therapy would lower cardiovascular events in high-risk patients with type 2 diabetes, compared with a statin alone.

Across 5,518 patients followed for a mean 4.7 years, the primary outcome (nonfatal MI, nonfatal stroke or cardiovascular death) ran at 2.2% a year with fenofibrate vs 2.4% with placebo (HR 0.92, P=0.32), with no difference on any secondary outcome.

Why it matched: same research area · similar wording

Extended-release niacin with laropiprant, added to statin therapy, would reduce major vascular events by further lowering LDL and raising HDL cholesterol.

In 25,673 adults with vascular disease over a median 3.9 years, major vascular events occurred in 13.2% on niacin-laropiprant vs 13.7% on placebo (rate ratio 0.96, P=0.29), while serious disturbances of diabetes control rose by 3.7 percentage points.

Why it matched: same research area

Serum syndecan-4, which rises after heart attacks and in heart failure, would mark heart scarring and heart dysfunction in people with chronic Chagas disease.

In 56 patients, syndecan-4 did not correlate with heart scarring (P = 0.386), disease severity (P = 0.918), or ejection fraction (r = 0.02). NT-proBNP did correlate with both.

Why it matched: similar wording