R&D Department, Ceva Santé Animale, Libourne, France.
J Vet Intern Med. 2010 Mar-Apr;24(2):331-41. doi: 10.1111/j.1939-1676.2009.0467.x.
Spironolactone, an aldosterone antagonist, has been demonstrated to decrease mortality in human patients when added to other cardiac therapies.
Spironolactone in addition to conventional therapy increases survival compared with conventional therapy in dogs with naturally occurring myxomatous mitral valve disease (MMVD).
Between February 2003 and March 2005, 221 dogs were recruited in Europe. Nine dogs were excluded from analysis, leaving 212 dogs with moderate to severe mitral regurgitation (MR) caused by MMVD (International Small Animal Cardiac Health Council classification classes II [n = 190] and III [n = 21]).
Double-blinded, field study conducted with dogs randomized to receive either spironolactone (2 mg/kg once a day) or placebo in addition to conventional therapy (angiotensin converting enzyme inhibitor, plus furosemide and digoxin if needed). Primary endpoint was a composite of cardiac-related death, euthanasia, or severe worsening of MR.
Primary endpoint reached by 11/102 dogs (10.8%) in the spironolactone group (6 deaths, 5 worsening) versus 28/110 (25.5%) in control group (14 deaths, 8 euthanasia, 6 worsening). Risk of reaching the composite endpoint significantly decreased by 55% (hazard ratio [HR] = 0.45; 95% confidence limits [CL], 0.22-0.90; log rank test, P = .017). Risk of cardiac-related death or euthanasia significantly reduced by 69% (HR = 0.31; 95% CL, 0.13-0.76; P = .0071). Number of dogs not completing the study for cardiac and other miscellaneous reasons similar in spironolactone (67/102) and control groups (66/110).
Spironolactone added to conventional cardiac therapy decreases the risk of reaching the primary endpoint (ie, cardiac-related death, euthanasia, or severe worsening) in dogs with moderate to severe MR caused by MMVD.
螺内酯，一种醛固酮拮抗剂，当添加到其他心脏治疗中时，已被证明可降低人类患者的死亡率。
螺内酯联合常规疗法比常规疗法更能提高患有自发性黏液瘤性二尖瓣疾病（MMVD）的犬的存活率。
2003 年 2 月至 2005 年 3 月期间，在欧洲招募了 221 只狗。9 只狗被排除在分析之外，剩下 212 只患有由 MMVD 引起的中度至重度二尖瓣反流（MR）的狗（国际小动物心脏健康理事会分类 II 级[ n = 190]和 III 级[n = 21]）。
对狗进行双盲、现场研究，随机分配接受螺内酯（2 mg/kg 每天一次）或安慰剂联合常规治疗（血管紧张素转换酶抑制剂，如果需要，加用呋塞米和地高辛）。主要终点是心脏相关死亡、安乐死或 MR 严重恶化的复合终点。
螺内酯组 11/102 只狗（10.8%）达到主要终点（6 只死亡，5 只恶化），而对照组 28/110 只（25.5%）达到主要终点（14 只死亡，8 只安乐死，6 只恶化）。达到复合终点的风险显著降低 55%（风险比[HR] = 0.45；95%置信区间[CL]，0.22-0.90；对数秩检验，P =.017）。心脏相关死亡或安乐死的风险显著降低 69%（HR = 0.31；95% CL，0.13-0.76；P =.0071）。因心脏和其他原因未完成研究的狗在螺内酯组（102 只中的 67 只）和对照组（110 只中的 66 只）中相似。
螺内酯联合常规心脏治疗可降低患有由 MMVD 引起的中度至重度 MR 的犬达到主要终点（即心脏相关死亡、安乐死或严重恶化）的风险。
