Document Detail


Efficacy of spironolactone on survival in dogs with naturally occurring mitral regurgitation caused by myxomatous mitral valve disease.
MedLine Citation:
PMID:  20102506     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Spironolactone, an aldosterone antagonist, has been demonstrated to decrease mortality in human patients when added to other cardiac therapies.
HYPOTHESIS: Spironolactone in addition to conventional therapy increases survival compared with conventional therapy in dogs with naturally occurring myxomatous mitral valve disease (MMVD).
ANIMALS: Between February 2003 and March 2005, 221 dogs were recruited in Europe. Nine dogs were excluded from analysis, leaving 212 dogs with moderate to severe mitral regurgitation (MR) caused by MMVD (International Small Animal Cardiac Health Council classification classes II [n = 190] and III [n = 21]).
METHODS: Double-blinded, field study conducted with dogs randomized to receive either spironolactone (2 mg/kg once a day) or placebo in addition to conventional therapy (angiotensin converting enzyme inhibitor, plus furosemide and digoxin if needed). Primary endpoint was a composite of cardiac-related death, euthanasia, or severe worsening of MR.
RESULTS: Primary endpoint reached by 11/102 dogs (10.8%) in the spironolactone group (6 deaths, 5 worsening) versus 28/110 (25.5%) in control group (14 deaths, 8 euthanasia, 6 worsening). Risk of reaching the composite endpoint significantly decreased by 55% (hazard ratio [HR] = 0.45; 95% confidence limits [CL], 0.22-0.90; log rank test, P = .017). Risk of cardiac-related death or euthanasia significantly reduced by 69% (HR = 0.31; 95% CL, 0.13-0.76; P = .0071). Number of dogs not completing the study for cardiac and other miscellaneous reasons similar in spironolactone (67/102) and control groups (66/110).
CONCLUSION AND CLINICAL IMPORTANCE: Spironolactone added to conventional cardiac therapy decreases the risk of reaching the primary endpoint (ie, cardiac-related death, euthanasia, or severe worsening) in dogs with moderate to severe MR caused by MMVD.
Authors:
F Bernay; J M Bland; J Häggström; L Baduel; B Combes; A Lopez; V Kaltsatos
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of veterinary internal medicine / American College of Veterinary Internal Medicine     Volume:  24     ISSN:  0891-6640     ISO Abbreviation:  J. Vet. Intern. Med.     Publication Date:    2010 Mar-Apr
Date Detail:
Created Date:  2010-05-17     Completed Date:  2010-06-03     Revised Date:  2010-12-10    
Medline Journal Info:
Nlm Unique ID:  8708660     Medline TA:  J Vet Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  331-41     Citation Subset:  IM    
Affiliation:
R&D Department, Ceva Santé Animale, Libourne, France. florence.bernay@ceva.com
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MeSH Terms
Descriptor/Qualifier:
Angiotensin-Converting Enzyme Inhibitors / administration & dosage,  therapeutic use
Animals
Cardiotonic Agents / administration & dosage,  therapeutic use
Digoxin / administration & dosage,  therapeutic use
Diuretics / therapeutic use*
Dog Diseases / drug therapy*
Dogs
Double-Blind Method
Drug Therapy, Combination
Female
Furosemide / administration & dosage,  therapeutic use
Male
Mitral Valve Insufficiency / drug therapy,  veterinary*
Proportional Hazards Models
Spironolactone / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Cardiotonic Agents; 0/Diuretics; 20830-75-5/Digoxin; 52-01-7/Spironolactone; 54-31-9/Furosemide
Comments/Corrections
Comment In:
J Vet Intern Med. 2010 Nov-Dec;24(6):1245-6; author reply 1247-8   [PMID:  21054535 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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