Actively Recruiting

Phase 3
Age: 50Years - 99Years
All Genders
ID02901184

Spironolactone Initiation Registry Randomized Interventional Trial in Heart Failure With Preserved Ejection Fraction, SPIRRIT-HFPEF

Led by Uppsala University · Updated on 2024-10-22

2000

Participants Needed

78

Research Sites

N/A

Total Duration

On this page

Sponsors

U

Uppsala University

Lead Sponsor

K

Karolinska University

Collaborating Sponsor

AI-Summary

What this Trial Is About

Researchers are evaluating the effect of spironolactone combined with standard care compared to standard care alone in patients with Heart Failure with Preserved Ejection Fraction (HFPEF). This condition is common and serious, but currently lacks effective treatment. The trial is a phase 3 Registry-Randomized Clinical Trial (RRCT) involving patients from the Swedish Heart Failure Registry and the US. HFPEF is defined by heart failure symptoms, elevated NT-proBNP levels, and an ejection fraction of 40% or higher. Participants will be randomly assigned to receive either spironolactone added to their usual care or usual care alone. Spironolactone will be given as 25 mg tablets, starting at 25 mg per day with a possible increase to 50 mg daily if tolerated. If spironolactone is not tolerated, eplerenone may be prescribed instead. The control group will continue with their standard care without spironolactone. The study duration is planned for 9 years, with enrollment lasting 7 years. During the study, researchers will collect data on cardiovascular death and hospitalizations due to heart failure as the primary outcomes. Secondary outcomes include hospitalizations for various causes, adverse events, and treatment adherence. In Sweden, outcomes will be obtained by linking national registries, while in the US, sites and call centers will report outcomes. The trial aims to enroll approximately 2000 patients, with follow-up continuing for at least 5 years after study start to monitor these outcomes.

CONDITIONS

Brief Title

Spironolactone Initiation Registry Randomized Interventional Trial in Heart Failure With Preserved Ejection Fraction

Who Can Participate

Age: 50Years - 99Years
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Written informed consent
  • Age 50 years or older
  • Stable heart failure defined by symptoms and signs judged by local Investigator
  • Left ventricular ejection fraction (LVEF) 40% or higher recorded in the last 12 months
  • Elevated natriuretic peptide levels defined by NT-proBNP or BNP thresholds depending on heart rhythm and BMI
  • Regular use of loop diuretics daily or most days of the week
  • New York Heart Association (NYHA) Class II to IV
Not Eligible

You will not qualify if you...

  • Previously enrolled in this study
  • Known ejection fraction less than 40% ever
  • Current absolute indication or contraindication for mineral receptor antagonist (MRA) as judged by Investigator
  • Known chronic liver disease
  • Alternative causes for symptoms such as primary cardiomyopathy, significant valve disease, right-sided heart failure not due to left-sided heart failure, or significant chronic pulmonary disease
  • Symptomatic anemia with hemoglobin less than 10 g/dL
  • Heart transplant or left ventricular assist device recipient
  • Presence of cardiac resynchronization therapy (CRT) device
  • Systolic blood pressure less than 90 or greater than 160 mmHg
  • Potassium level greater than 5.0 mmol/L
  • Estimated glomerular filtration rate (eGFR) less than 30 ml/min/1.73m2 or creatinine greater than 2.5 mg/dL
  • Current lithium use
  • Current dialysis
  • Actual or potential pregnancy
  • Participation in another interventional trial studying mineralocorticoid receptor antagonists
  • Any condition that may interfere with adherence to trial protocol as judged by Investigator

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

Treatment

Duration - Up to 5 years

Participants receive Spironolactone tablets on top of standard care or standard care alone to manage heart failure with preserved ejection fraction.

Trial Site Locations

Total: 78 locations

1

Advanced Cardiovascular LLC

Alexander City, Alabama, United States, 35010

Terminated

2

University of Alabama at Birmingham

Birmingham, Alabama, United States, 35294

Terminated

3

Banner - University Medical Group

Tucson, Arizona, United States, 85724

Terminated

4

MedStar Cardiovascular Research Network

Washington D.C., District of Columbia, United States, 20010

Terminated

5

Howard University Hospital

Washington D.C., District of Columbia, United States, 20060

Terminated

6

Holy Cross Hospital

Fort Lauderdale, Florida, United States, 33308

Terminated

7

Piedmont Atlanta Hospital

Atlanta, Georgia, United States, 30309

Terminated

8

Wellstar Health System, Inc.

Marietta, Georgia, United States, 30060

Terminated

9

Queens Medical Center

Honolulu, Hawaii, United States, 96813

Terminated

10

Fox Valley Clinical Research Center, LLC

Aurora, Illinois, United States, 60506-1400

Terminated

11

University of Illinois at Chicago

Chicago, Illinois, United States, 60612

Terminated

12

Alexian Brothers Medical Center

Elk Grove Village, Illinois, United States, 60007

Terminated

13

Methodist Medical Center of Illinois

Peoria, Illinois, United States, 61636

Terminated

14

St. Vincent Medical Group

Indianapolis, Indiana, United States, 46260

Terminated

15

Ochsner Medical Center

New Orleans, Louisiana, United States, 85724

Terminated

16

Shady Grove Adventist Hospital

Rockville, Maryland, United States, 20850

Terminated

17

Brigham and Women's Hospital

Boston, Massachusetts, United States, 02115

Terminated

18

Pentucket Medical Associates

Haverhill, Massachusetts, United States, 01830

Terminated

19

Charles River Medical Associates

Natick, Massachusetts, United States, 01760

Terminated

20

Newton-Wellesley Hospital

Newton, Massachusetts, United States, 02462

Terminated

21

University of Michigan Medical Center

Ann Arbor, Michigan, United States, 48109

Terminated

22

Ascension Genesys Hospital

Grand Blanc, Michigan, United States, 48439

Terminated

23

The Heart House Haddon Heights

Haddon Heights, New Jersey, United States, 08035

Terminated

24

Rutgers University - Robert Wood Johnson Medical School

New Brunswick, New Jersey, United States, 08901

Terminated

25

University of New Mexico Health Science Center

Albuquerque, New Mexico, United States, 87131

Terminated

26

University at Buffalo

Buffalo, New York, United States, 14203

Terminated

27

Northwell Health - Manhasset

Manhasset, New York, United States, 11030

Terminated

28

Mount Sinai Medical Cente

New York, New York, United States, 10029

Terminated

29

Mid Carolina Cardiology Research

Charlotte, North Carolina, United States, 28204

Terminated

30

Duke University

Durham, North Carolina, United States, 27710-4000

Terminated

31

University of Cincinnati Medical Center

Cincinnati, Ohio, United States, 45267-0542

Terminated

32

Penn State Milton S Hershey Medical Center

Hershey, Pennsylvania, United States, 17033

Terminated

33

Jefferson University Hospital

Philadelphia, Pennsylvania, United States, 19107

Terminated

34

University of Pittsburgh Medical Center

Pittsburgh, Pennsylvania, United States, 15213

Terminated

35

Stern Cardiovascular Center

Germantown, Tennessee, United States, 38138

Terminated

36

Baylor University Medical Center

Dallas, Texas, United States, 75246

Terminated

37

University of Miami Hospital

Miami, Texas, United States, 33136

Terminated

38

University of Texas Health Science Center at San Antonio

San Antonio, Texas, United States, 78229

Terminated

39

Angereds närsjukhus

Angered, Sweden

Terminated

40

Hälsostaden Ängelholms sjukhus

Ängelholm, Sweden

Terminated

41

Falu lasarett

Falun, Sweden

Actively Recruiting

42

Närsjukvården i Finspång

Finspång, Sweden

Terminated

43

Vårdcentralen Centrum i Flen

Flen, Sweden

Actively Recruiting

44

Sahgrenska University Hospital Östra

Gothenburg, Sweden

Actively Recruiting

45

Sahlgrenska Universitetssjukhuset

Gothenburg, Sweden

Actively Recruiting

46

Hemse Vårdcentral

Hemse, Sweden

Actively Recruiting

47

Karolinska University Hospital

Huddinge, Sweden

Actively Recruiting

48

Länssjukhuset Ryhov

Jönköping, Sweden, 55185

Actively Recruiting

49

Blekingesjukhuset

Karlskrona, Sweden, 37185

Active, Not Recruiting

50

Hjärtmottagningen, Centralsjukhuset

Karlstad, Sweden, 65230

Actively Recruiting

51

Västmanlands sjukhus Köping

Köping, Sweden

Actively Recruiting

52

Centralsjukhuset Kristianstad

Kristianstad, Sweden

Terminated

53

Lasarettet i Landskrona

Landskrona, Sweden

Actively Recruiting

54

Skaraborgs sjukhus i Lidköping

Lidköping, Sweden

Actively Recruiting

55

Linköpings Universitetssjukhus

Linköping, Sweden, 58185

Actively Recruiting

56

VO Akut- och internmedicin, Skånes Universitetssjukhus

Lund, Sweden, 22185

Terminated

57

Capio Citykliniken

Lund, Sweden

Actively Recruiting

58

FO Kranskärl/Svikt, Skånes Universitetssjukhus

Lund, Sweden

Actively Recruiting

59

Hjärtavdelningen, Skånes Universitetssjukhus

Malmö, Sweden, 20502

Terminated

60

Kliniska forskningsenheten Skånes Universitetssjukhus

Malmö, Sweden

Actively Recruiting

61

Mariefreds Vårdcentral

Mariefred, Sweden

Actively Recruiting

62

Sahlgrenska University Hospital Mölndal

Mölndal, Sweden

Actively Recruiting

63

Kardiologikliniken, Vrinnevisjukhuset

Norrköping, Sweden, 60182

Actively Recruiting

64

Oskarshamns sjukhus

Oskarshamn, Sweden

Active, Not Recruiting

65

Örebro University Hospital

Örebro, Sweden

Actively Recruiting

66

Skellefteå lasarett

Skellefteå, Sweden

Actively Recruiting

67

Karolinska University Hospital

Solna, Sweden

Actively Recruiting

68

Södertälje sjukhus

Södertälje, Sweden

Terminated

69

VO Kardiologi, Södersjukhuset AB

Stockholm, Sweden, 11883

Actively Recruiting

70

Capio S:t Görans sjukhus AB

Stockholm, Sweden

Actively Recruiting

71

Danderyds sjukhus AB

Stockholm, Sweden

Actively Recruiting

72

Länssjukhuset Sundsvall-Härnösand

Sundsvall, Sweden

Actively Recruiting

73

Sundsvalls Vårdcentral

Sundsvall, Sweden

Terminated

74

Uppsala University Hospital, Cardiology dept

Uppsala, Sweden

Actively Recruiting

75

Uppsala University Hospital, Internal Medicine dept

Uppsala, Sweden

Actively Recruiting

76

Medicinkliniken, Hallands sjukhus

Varberg, Sweden, 43281

Actively Recruiting

77

Västmanlands sjukhus Västerås

Västerås, Sweden

Actively Recruiting

78

Västerviks sjukhus

Västervik, Sweden

Active, Not Recruiting

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Research Team

A

Anna Gustavsson (SWE)

W

Will Simmons (US)

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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