{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:06:04Z","timestamp":1791446764526,"version":"4.3.3"},"reference-count":29,"publisher":"Sociedade Brasileira de Cardiologia","issue":"4","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Bras. Cardiol."],"abstract":"<jats:p>Resumo A insufici\u00eancia card\u00edaca com fra\u00e7\u00e3o de eje\u00e7\u00e3o preservada (ICFEp) ou levemente reduzida (ICFElr) \u00e9 uma condi\u00e7\u00e3o prevalente associada \u00e0 significativa morbidade e mortalidade em que os benef\u00edcios dos antagonistas dos receptores de mineralocorticoides (ARMs) ainda n\u00e3o s\u00e3o claros. Nosso objetivo foi desenvolver uma revis\u00e3o sistem\u00e1tica sobre o uso de ARMs em pacientes com ICFEp ou ICFElr. Foi realizada uma revis\u00e3o sistem\u00e1tica com metan\u00e1lise, utilizando uma estrat\u00e9gia de busca ampla nas bases de dados MEDLINE, Embase e Cochrane Central Register of Controlled Trials (CENTRAL). Foram inclu\u00eddos ensaios cl\u00ednicos randomizados que avaliaram o uso de ARMs em pacientes com ICFEp, comparados a grupos controle. A qualidade da evid\u00eancia e a for\u00e7a da recomenda\u00e7\u00e3o foram avaliadas segundo a metodologia Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Oito estudos foram inclu\u00eddos. N\u00e3o foram observadas diferen\u00e7as estatisticamente significativas para os desfechos de mortalidade geral e mortalidade cardiovascular em compara\u00e7\u00e3o ao grupo controle para qualquer dos ARMs. Identificou-se benef\u00edcio na redu\u00e7\u00e3o do risco de hospitaliza\u00e7\u00e3o por insufici\u00eancia card\u00edaca (risco relativo: 0,87; intervalo de confian\u00e7a de 95%: 0,79 a 0,96; certeza da evid\u00eancia moderada) e piora da insufici\u00eancia card\u00edaca (risco relativo: 0,83; intervalo de confian\u00e7a de 95%: 0,77 a 0,89; certeza da evid\u00eancia alta). Os resultados da metan\u00e1lise indicam significativo benef\u00edcio dos ARMs, espironolactona ou finerenona, para redu\u00e7\u00e3o de hospitaliza\u00e7\u00f5es e eventos de piora da insufici\u00eancia card\u00edaca em pacientes com ICFEp ou ICFElr.<\/jats:p>","DOI":"10.36660\/abc.20250622","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T16:33:12Z","timestamp":1784651592000},"source":"Crossref","is-referenced-by-count":1,"title":["Revis\u00e3o Sistem\u00e1tica: Antagonistas dos Receptores de Mineralocorticoides na Insufici\u00eancia Card\u00edaca com Fra\u00e7\u00e3o de Eje\u00e7\u00e3o Preservada e Levemente Reduzida"],"prefix":"10.36660","volume":"123","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6553-8387","authenticated-orcid":false,"given":"Marcus Vinicius","family":"Sim\u00f5es","sequence":"first","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5774-2780","authenticated-orcid":false,"given":"Luiz Claudio","family":"Danzmann","sequence":"additional","affiliation":[{"name":"Universidade Luterana do Brasil,  Brasil; Hospital S\u00e3o Lucas da PUCRS,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3093-9743","authenticated-orcid":false,"given":"S\u00edlvia Marinho","family":"Martins","sequence":"additional","affiliation":[{"name":"Pronto Socorro Cardiol\u00f3gico de Pernambuco,  Brasil; Real Hospital Portugu\u00eas de Benefic\u00eancia em Pernambuco,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3739-7702","authenticated-orcid":false,"given":"Jos\u00e9 Albuquerque de","family":"Figueiredo Neto","sequence":"additional","affiliation":[{"name":"Universidade Federal do Maranh\u00e3o,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2533-5638","authenticated-orcid":false,"given":"Fabiana G.","family":"Marcondes-Braga","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2501-302X","authenticated-orcid":false,"given":"Ricardo","family":"Mourilhe-Rocha","sequence":"additional","affiliation":[{"name":"Universidade do Estado do Rio de Janeiro,  Brasil; Hospital Pr\u00f3-Card\u00edaco \u2013 Am\u00e9ricas Servi\u00e7os M\u00e9dicos,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1883-6546","authenticated-orcid":false,"given":"Denilson Campos de","family":"Albuquerque","sequence":"additional","affiliation":[{"name":"Universidade do Estado do Rio de Janeiro,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9413-3792","authenticated-orcid":false,"given":"Mucio Tavares de","family":"Oliveira Jr","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia Ana Zytynski","family":"Moura","sequence":"additional","affiliation":[{"name":"Pontif\u00edcia Universidade Cat\u00f3lica do Paran\u00e1,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"22636","published-online":{"date-parts":[[2026]]},"reference":[{"issue":"10","key":"ref1","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1056\/NEJM199909023411001","article-title":"The Effect of Spironolactone on Morbidity and Mortality in Patients with Severe Heart Failure","volume":"341","author":"Pitt B","year":"1999","journal-title":"N Engl J 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