title: Effect of Spironolactone on Plasma Apelin-12 Levels in Patients with Chronic Systolic Heart Failure.
abstract: BACKGROUND
  The aim of this study was to determine whether spironolactone therapy has an effect on serum apelin-12 levels in heart failure with reduced ejection fraction (HFrEF) patients.
  
  
  METHODS
  Eighty outpatients previously diagnosed with HFrEF were enrolled in the current study. Included patients were taking only standard heart failure therapy (ST) (angiotensin converting enzyme or angiotensin receptor blocker, beta-blockers, loop diuretics and anticoagulant or antiagregan agents) without a mineralocorticoid receptor antagonists (MRA) because of its side effects, and were designated the non-MRA group; those patients taking 25 mg/daily spironolactone in addition to the ST were deemed the MRA group. Patient blood samples were collected to measure serum apelin-12 levels.
  
  
  RESULTS
  After adjustment for all clinical and demographic factors, plasma apelin-12 levels were significantly higher and NT pro-BNP levels were significantly lower in the MRA group compared to the non-MRA group (p < 0.001, p < 0.001; respectively). In multiple linear regression analyses, there was no association between baseline apelin-12 level and clinical parameters. MRA using initial apelin-12 levels were lower and NT pro-BNP levels were higher in patients with stricken event than in event-free patients (p = 0.042, p < 0.001, and p < 0.001; respectively).
  
  
  CONCLUSIONS
  Blocking the aldosterone receptors by spironolactone, in addition to maximal standard therapy, may increase serum apelin-12 levels among patients with HFrEF.
authors.affiliation: Department of Cardiology, University of Health Sciences, Adana Numune Education and Research Hospital.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Topuz
authors.affiliation: Department of Cardiology, University of Health Sciences, Adana Numune Education and Research Hospital.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Cosgun
authors.affiliation: Department of Cardiology, University of Health Sciences, Adana Numune Education and Research Hospital.
authors.forename: Oğuz
authors.initials: O
authors.lastname: Akkuş
authors.affiliation: Department of Cardiology, University of Health Sciences, Adana Numune Education and Research Hospital.
authors.forename: Atilla
authors.initials: A
authors.lastname: Bulut
authors.affiliation: Department of Cardiology, University of Health Sciences, Adana Numune Education and Research Hospital.
authors.forename: Omer
authors.initials: O
authors.lastname: Sen
authors.affiliation: Family Medicine, Cukurova Medical Universty, Adana, Turkey.
authors.forename: Ayşe Nur
authors.initials: AN
authors.lastname: Topuz
authors.affiliation: Department of Cardiology, University of Health Sciences, Adana Numune Education and Research Hospital.
authors.forename: Murat
authors.initials: M
authors.lastname: Caylı
keywords: Aldosterone antagonist; Apelin-12; Heart failure