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Ahhh!! I mixed up my studies, that didn't happen in the PARADIGM-HF study. It has other limitations, but I was thinking of TOPCAT.


From briefly reading the paper and the post-hoc analysis, it seems that they were very clear about their post-hoc analysis and its limitations. In this situation, whoever are reading into it more than they should (could be novartis and their marketing, could also be the physician colleagues of yours) are the ones that should be criticized, not the authors themselves.

Edit: here are some quotes from the author of the post-hoc analysis

"Referring to the fact that these observations came from a post hoc analysis, Pfeffer said: 'I normally draw a line here, and I wouldn't cross this line if we had things to do for these patients.'

But he added: 'This is a growing part of the heart-failure syndrome. And if we have something that can help these 40% to 50% of people with symptomatic heart failure and an impaired prognosis—if we can improve their prognosis and take care of the safety measures—then I will go below this line by stating that our observations in the Americas—that spironolactone was associated with reduced CV deaths and hospitalizations for CHF—should be taken into account.'"




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