Effects of mineralocorticoid receptor antagonists on the risk of thrombosis, bleeding and mortality: A systematic review and meta-analysis of randomized controlled trials

Elbers, Laura; Sjouke, Barbara; Zannad, Faı̈ez; Cicoira, Mariantonietta; Vizzardi, Enrico; Václavík, J.; Gerdes, Victor E. A.; Squizzato, Alessandro

doi:10.1016/j.thromres.2016.04.027

Cited by 5 publications

(1 citation statement)

References 35 publications

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“…43 However, a large meta-analysis did not find any impact of MR antagonism on the incidence of bleeding or thrombotic events in human clinical trials. 44 Aldosterone may be pro-thrombotic specifically in the context of vascular damage which, like vasoconstriction, could be induced by cardiometabolic risk factors or mechanical damage. Aldosterone application to an intact, non-damaged EC monolayer decreased thrombin formation.…”

Section: Mr In Thrombosismentioning

confidence: 99%

Vascular Mineralocorticoid Receptor: Evolutionary Mediator of Wound Healing Turned Harmful by Our Modern Lifestyle

Biwer

Wallingford

Jaffe

2018

American Journal of Hypertension

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Section: Mr In Thrombosismentioning

confidence: 99%

Vascular Mineralocorticoid Receptor: Evolutionary Mediator of Wound Healing Turned Harmful by Our Modern Lifestyle

Biwer

Wallingford

Jaffe

2018

American Journal of Hypertension

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Mineralocorticoid receptor antagonists in patients with acute myocardial infarction — A systematic review and meta-analysis of randomized trials

Bossard

Binbraik

Beygui

et al. 2018

American Heart Journal

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Aldosterone and cardiovascular diseases

Parksook

Williams

2022

Cardiovascular Research

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Aldosterone’s role in the kidney and its pathophysiologic actions in hypertension are well known. However, its role or that of its receptor [minieralocorticoid receptor (MR)] in other cardiovascular (CV) disease are less well described. To identify their potential roles in six CV conditions (heart failure, myocardial infarction, atrial fibrillation, stroke, atherosclerosis, and thrombosis), we assessed these associations in four areas: 1) mechanistic studies in rodents and humans; 2) preclinical studies of MR antagonists; 3) clinical trials of MR antagonists; and 4) genetics. The data were acquired from an online search of the National Library of Medicine using the PubMed search engine from January 2011 through June 2021. There were 3702 publications identified with 156 publications meeting our inclusion and exclusion criteria. Data strongly supported an association between heart failure and dysregulated aldosterone/MR. This association is not surprising given aldosterone/MR’s prominent role in regulating sodium/volume homeostasis. Atrial fibrillation and myocardial infarction are also associated with dysregulated aldosterone/MR, but less strongly. For the most part, the data were insufficient to determine if there was a relationship between atherosclerosis, stroke or thrombosis and aldosterone/MR dysregulation. This review clearly documented an expanding role for aldosterone/MR’s dysregulation in CV diseases beyond hypertension. How expansive it might be is limited by the currently available data. It is anticipated that with an increased focus on aldosterone/MR’s potential roles in these diseases, additional clinical and preclinical data will clarify these relationships, thereby, opening approaches to use modulators of aldosterone/MR’s action to more precisely treat these CV conditions.

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Effects of mineralocorticoid receptor antagonists on the risk of thrombosis, bleeding and mortality: A systematic review and meta-analysis of randomized controlled trials

Cited by 5 publications

References 35 publications

Vascular Mineralocorticoid Receptor: Evolutionary Mediator of Wound Healing Turned Harmful by Our Modern Lifestyle

Vascular Mineralocorticoid Receptor: Evolutionary Mediator of Wound Healing Turned Harmful by Our Modern Lifestyle

Mineralocorticoid receptor antagonists in patients with acute myocardial infarction — A systematic review and meta-analysis of randomized trials

Aldosterone and cardiovascular diseases

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