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Previous Volume 346:946-947 March 21, 2002 Number 12 Next

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To the Editor: Spironolactone should be added to Table 2 of the article by Huikuri et al. (Nov. 15 issue)¹ as an intervention that may prevent sudden death from cardiac causes. In the Randomized Aldactone Evaluation Study,² patients with New York Heart Association class III or IV congestive heart failure who were randomly assigned to receive daily spironolactone had a lower risk of sudden death than patients who were randomly assigned to receive placebo (relative risk, 0.71; 95 percent confidence interval, 0.54 to 0.95; P=0.02). Possible mechanisms of this protective effect include potentiation of diuretic-induced hypokalemia as well as neurohormonal . . . [Full Text of this Article]

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