(i) Peto odds ratio due to zero events in one trial.j Downgraded by 1 increment because: Heterogeneity, I2=59%, unexplained by subgroup analysis. Chronic Heart Failure Treating Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 6.2.4.4 Economic evidence Published literature No economic evaluations were identified in the 2003 guideline (CG5). Two studies were included in the 2010 guideline update (CG108): one Irish cost-effectiveness study assessing the addition of spironolactone to optimal medical treatment based on the RALES trial for patients with severe heart failure (NYHA class III-IV) and LVSD,334 which is included in this review and is summarised in the health economic profile below (Table 49) and the health economic evidence table in Appendix G; and one UK cost-effectiveness study assessing the addition of eplerenone to optimal medical treatment based on the EPHESUS trial for patients with heart failure and LVSD, post-acute myocardial which has been excluded from this review as this population is no longer included in the scope of this guideline. This population is now covered in the Acute Heart Failure guideline (CG187). Five additional health economic studies were identified with the relevant comparison from the update searches. One study is included in this review, and is summarised in the health economic evidence profile below (Table 49) and the health economic evidence tables in Appendix G. 194 The other studies were selectively excluded due to the availability of more applicable evidence. 2, 3,21,332 These are listed in Appendix I, with reasons for exclusion given. See also the health economic study selection flow chart in Appendix D. Treating Heart Failure Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. 