Impact of Mineralocorticoid Receptor Antagonists on the Risk of Sudden Cardiac Death Across Cardio-Kidney-Metabolic Diseases: A Meta-Analysis of Randomized Clinical Trials
Bibliographic record
Abstract
Aims Sudden cardiac death (SCD) is a prevalent cause of mortality among patients with cardio-kidney-metabolic (CKM) diseases. Mineralocorticoid receptor antagonists (MRAs) reduce the risk of SCD in patients with left ventricular dysfunction, but it is unclear if similar effects are expected across different CKM risk populations irrespective of ejection fraction. Methods and results A random-effects meta-analysis of randomized clinical trials (RCTs) of MRA (vs. placebo) on the occurrence of SCD was performed. The number of reported SCD events were collected from the individual RCTs and the respective odds ratio (OR) and 95% confidence intervals (95% CI) calculated. Data from five major RCTs were collected including over 31 000 patients. Overall, MRAs, compared with placebo, reduced the occurrence of SCD (OR 0.79, 95% CI 0.70–0.89, p < 0.001). No significant heterogeneity was found across trials (I2 = 0%, Q = 0.38, p = 0.98). Conclusion This meta-analysis supports the benefit of MRAs for SCD risk reduction across CKM risk and irrespective of ejection fraction.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.025 | 0.022 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.007 | 0.016 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".