Chronic Heart Failure Treating Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 Study Intervention and comparison Population Outcomes Comments Tsutsui mg / day) Comparison: Placebo years with NYHA class II heart failure or higher, and LVEF 30% (or 35% if also QRS duration treatment with ACE inhibitor, ARB, - blocker, or diuretic. Patients were within 6 months of hospitalisation for CV reason (or high levels of BNP/NTpro-BNP). Adverse events (renal impairment, hyperkalaemia, hypotension, gynaecomastia) Higher incidence of diabetes, angina pectoris and coronary artery bypass grafting in the placebo group. Maximum of 4 yrs intervention plus 1 year follow-up. RALES Intervention: Spironolactone (up to 50 mg / day) Control: Placebo People with NYHA class IV heart failure in previous six months (class III or IV at time of enrolment) and LVEF 35%, treatment with ACEI, loop diuretic and (in most cases) digoxin. on ACEI. Mortality Hospitalisation (for cardiac causes) Change in NYHA class Adverse events (renal function, gynaecomastia, hyperkalaemia) Severe heart failure population. Most patients not on beta-blockers. Trial was stopped early based on the interim results and the advice of the data and safety monitoring board . Trial had a mean follow-up period of 24 months. Trial included in 2010 guideline. Udelson Intervention: Eplerenone (50 mg / day) Control: Placebo People aged 21 years with NYHA class II or III health failure and LVEF with ACEI and/or ARB and BB (unless documented intolerance). ACEI and/or ARB. NYHA class Adverse events (hyperkalaemia, renal function, hypotension) Moderate severity heart failure population. Quality of life (Kansas City) results not extracted as only reported narratively (p value). Treating Heart Failure Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. 