Treating Heart Failure Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: Table 48: Clinical evidence summary: Mineralocorticoid receptor antagonists versus placebo for heart failure with reduced ejection fraction Outcomes No of Participants (studies) Follow up Quality of the evidence (GRADE) Relative effect Anticipated absolute effects Risk with Placebo Risk difference with Mineralocorticoid receptor antagonist (95% CI) All-cause mortality 4621 VERY LOWa, b, c due to inconsistency, indirectness, imprecision (from 57 fewer to 0 more) All-cause hospitalisation 4400 VERY LOWa, b,j due to indirectness, imprecision, inconsistency Rate Ratio 397 events per 1000 person- yearsd 83 fewer events per 1000 person years (from 52 fewer to 115 fewer) Hospitalisation for any cause (dichotomous) VERY LOWb,e due to risk of bias, imprecision (from 221 fewer to 11 more) Change in NYHA class - Improved 1456 VERY LOWa,b,e due to risk of bias, indirectness, imprecision (from 33 more to 152 more) Treating Heart Failure Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. 