{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T23:06:00Z","timestamp":1781305560474,"version":"3.54.1"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":1939,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T00:00:00Z","timestamp":1598572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Guideline-directed medical therapy (GDMT) including beta-blockers and renin\u2013angiotensin system inhibitors is shown to reduce mortality risk in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF). However, there is little evidence about the efficacy of additional administration of mineralocorticoid receptor antagonists (MRAs) with GDMT in patients \u226580 years presenting with HF. We aimed to investigate the prognostic impact of GDMT with MRA in relation to the age of patients with HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This observational study included patients admitted for HF with reduced LVEF who were discharged alive; among them, 224 patients were \u226580 years, and 661 patients were &amp;lt;80 years. Both populations were divided into three groups depending on whether they received GDMT with or without MRA or single\/no GDMT drugs (GDMT+MRA+, GDMT+MRA\u2212, or non-GDMT, respectively). The primary endpoint was all-cause mortality. In patients \u226580 years, all-cause mortality was the lowest in the GDMT+MRA+ group (log-rank trend, P = 0.034), and no significant differences were observed between the GDMT+MRA\u2212 and non-GDMT groups. Multivariate Cox regression analysis revealed that GDMT+MRA+ was superior to GDMT+MRA\u2212, even after adjusting for parameters at discharge (hazard ratio: 0.32, 95% confidence interval: 0.11\u20130.99). In patients &amp;lt;80 years, GDMT reduced all-cause mortality; however, additional MRA was not associated with an improved outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The results of this study suggest that additional MRA to GDMT at discharge is one of the therapeutic options for elderly HF patients with reduced LVEF. This finding is not well documented in previous clinical trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.12862","type":"journal-article","created":{"date-parts":[[2020,8,29]],"date-time":"2020-08-29T03:01:32Z","timestamp":1598670092000},"page":"2711-2724","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Prognostic Impact of Additional Mineralocorticoid Receptor Antagonists in Octogenarian Heart Failure Patients"],"prefix":"10.1093","volume":"7","author":[{"given":"Takuro","family":"Abe","sequence":"first","affiliation":[{"name":"Department of Cardiology, Tokyo Women's Medical University , 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-0054 ,","place":["Japan"]},{"name":"Department of Cardiology, Nishiarai Heart Center Hospital , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2011-8204","authenticated-orcid":false,"given":"Kentaro","family":"Jujo*","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tokyo Women's Medical University , 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-0054 ,","place":["Japan"]},{"name":"Department of Cardiology, Nishiarai Heart Center Hospital , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motoko","family":"Kametani","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tokyo Women's Medical University , 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-0054 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Minami","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tokyo Women's Medical University , 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-0054 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