To the Editor We read with interest the article published in JAMA Cardiology titled “Efficacy and Safety of Spironolactone in Acute Heart Failure: The ATHENA-HF Randomized Clinical Trial” by Butler et al.1 However, we would like to point out some caveats in this study and suggest improvements for future acute heart failure (AHF) trials involving mineralocorticoid receptor antagonists.
Ferreira JP, Girerd N, Zannad F. Interpretation of the ATHENA Trial—Caveats and Future Directions. JAMA Cardiol. 2018;3(1):89–90. doi:10.1001/jamacardio.2017.4370
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