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Updated May 2026 · ClinicalTrials.gov

RECRUITINGPhase 3INTERVENTIONAL

Spironolactone Initiation Registry Randomized Interventional Trial in Heart Failure With Preserved Ejection Fraction

Spironolactone Initiation Registry Randomized Interventional Trial in Heart Failure With Preserved Ejection Fraction, SPIRRIT-HFPEF

Spironolactone Initiation Registry Randomized Interventional Trial in Heart Failure With Preserved Ejection Fraction (NCT02901184) is a Phase 3 interventional studying Heart Failure With Preserved Ejection Fraction, sponsored by Uppsala University. RECRUITING as of the most recent ClinicalTrials.gov update. Talk to your doctor before contacting the trial site.

Important: This information is not medical advice. Talk to your doctor about whether a clinical trial is right for you.

About This Trial

Heart failure with preserved ejection fraction (HFPEF) is common and deadly but without therapy. Inconclusive studies such as TOPCAT (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) suggest spironolactone may be effective in HFPEF, but it is generic and will not be studied by industry. SPIRRIT is a unique Registry-Randomized Clinical Trial (RRCT) that will test the hypothesis that spironolactone plus standard of care compared to standard of care alone reduces the composite of CV mortality and HF hospitalization as follows: Population: HFPEF patients in the Swedish Heart Failure Registry and HFPEF patients in US. HFPEF defined as symptoms/signs of HF, elevated NTproBNP (B-type Natriuretic Peptide; N-terminal pro b-type Natriuretic Peptide) and EF\>=40%. Intervention and control: Randomized 1:1 to intervention: spironolactone + usual care vs. control: usual care alone. Outcome: Primary outcome cardiovascular death or time to HF hospitalization. Secondary outcomes include hospitalization for various causes, adverse events and treatment adherence. In Sweden outcomes are obtained automatically by linking with the Population, Patient and Drug Dispensed Registries. In the US, outcomes will be reported by sites and supplemented by data from a call center. The trial is event-driven with enrollment 7 years and study duration 9 years. For the primary outcome (CV Death or first HF hospitalization) with an event target of 721 events the sample size requires 1985 patients conservatively rounded to approximately 2000 patients.

What Stage of Research Is This?

Phase 3 trials confirm efficacy and safety in large patient groups (often 300–3,000+) and form the evidence base for an FDA approval submission. For Heart Failure With Preserved Ejection Fraction, Phase 3 studies typically randomize participants between the investigational treatment and either a placebo or current standard of care. A successful Phase 3 result is the threshold most treatments need to clear before regulatory approval.

This trial is currently recruiting participants. The sponsor has registered the study with ClinicalTrials.gov as actively enrolling, which means new applicants who meet the eligibility criteria can be considered for screening. Trial status can change between updates — confirm current recruiting status with the study contact before traveling for a screening visit.

Target enrollment of 2,000 participants makes this one of the larger Heart Failure With Preserved Ejection Fraction trials currently registered. Trials at this scale are typically global, run across many sites, and designed to generate the definitive evidence package for an FDA approval submission or a label expansion.

Who May Be Eligible (Plain English)

Who May Qualify: - Written willing to sign a consent form - Age ≥50 years - Stable heart failure defined by symptoms and signs of heart failure as judged by local Investigator - Left ventricular ejection fraction (LVEF) ≥40% recorded in last 12 months (stratified to max 2/3rd in either 40-49% or ≥50% group) - Elevated natriuretic peptide levels, as defined by any of the following: 1. most recent NT-proBNP \>300 ng/L (or BNP\>100 pg/mL) in sinus rhythm at time of blood sampling; adjustments may be made for BMI according to table 3. 2. most recent NT-proBNP \>750 ng/L (or BNP \>250 pg/mL) in atrial fibrillation at time of blood sampling; adjustments may be made for BMI according to table 3. 3. NT-proBNP \>1200 ng/L (or BNP \>400 pg/mL) within the last 12 months even if most recent value is lower. - Regular use of loop diuretics, defined as daily or most days of the week - NYHA Class II-IV Who Should NOT Join This Trial: Previously enrolled in this study - Known Ejection Fraction \< 40% ever - Current absolute indication or contraindication for MRA (mineral receptor antagonist) in judgement of Investigator - Known chronic liver disease - Probable alternative explanations for symptoms: - Known primary cardiomyopathy (hypertrophic, constrictive, restrictive, infiltrative, congenital) - Primary hemodynamically significant valve disease - Right-sided HF not due to left-sided HF - Significant chronic pulmonary disease defined by Investigator or by requirement for home O2 - Symptomatic anemia, defined as Hemoglobin \< 10 g/dL (100 g/L ) - Heart transplant or LVAD (left ventricular assist device) recipient - Presence of cardiac resynchronization therapy (CRT) device - Systolic blood pressure \<90 or \>160 mmHg - K (potassium) \>5.0 mmol/L - eGFR (estimated glomerular filtration rate) by MDRD (Modification of Diet in Renal Disease) \< 30 ml/min/1.73m2 or creatinine \> 2.5 mg/dL (221 µmol/L ) - Current lithium use - Current dialysis - Actual or potential for pregnancy ...See full criteria on ClinicalTrials.gov Always talk to your doctor about whether this trial is right for you.

These are translations of the protocol\'s inclusion and exclusion criteria, simplified for patients and caregivers. The original clinical text appears below. Eligibility is ultimately confirmed by the trial site\'s screening process — this summary is a starting point for a conversation with your doctor, not a final determination.

Original Eligibility Criteria

View original clinical language
Inclusion Criteria: * Written informed consent * Age ≥50 years * Stable heart failure defined by symptoms and signs of heart failure as judged by local Investigator * Left ventricular ejection fraction (LVEF) ≥40% recorded in last 12 months (stratified to max 2/3rd in either 40-49% or ≥50% group) * Elevated natriuretic peptide levels, as defined by any of the following: 1. most recent NT-proBNP \>300 ng/L (or BNP\>100 pg/mL) in sinus rhythm at time of blood sampling; adjustments may be made for BMI according to table 3. 2. most recent NT-proBNP \>750 ng/L (or BNP \>250 pg/mL) in atrial fibrillation at time of blood sampling; adjustments may be made for BMI according to table 3. 3. NT-proBNP \>1200 ng/L (or BNP \>400 pg/mL) within the last 12 months even if most recent value is lower. * Regular use of loop diuretics, defined as daily or most days of the week * NYHA Class II-IV Exclusion Criteria: Previously enrolled in this study * Known Ejection Fraction \< 40% ever * Current absolute indication or contraindication for MRA (mineral receptor antagonist) in judgement of Investigator * Known chronic liver disease * Probable alternative explanations for symptoms: * Known primary cardiomyopathy (hypertrophic, constrictive, restrictive, infiltrative, congenital) * Primary hemodynamically significant valve disease * Right-sided HF not due to left-sided HF * Significant chronic pulmonary disease defined by Investigator or by requirement for home O2 * Symptomatic anemia, defined as Hemoglobin \< 10 g/dL (100 g/L ) * Heart transplant or LVAD (left ventricular assist device) recipient * Presence of cardiac resynchronization therapy (CRT) device * Systolic blood pressure \<90 or \>160 mmHg * K (potassium) \>5.0 mmol/L * eGFR (estimated glomerular filtration rate) by MDRD (Modification of Diet in Renal Disease) \< 30 ml/min/1.73m2 or creatinine \> 2.5 mg/dL (221 µmol/L ) * Current lithium use * Current dialysis * Actual or potential for pregnancy * Participation in another interventional clinical trial where a mineralocorticoid receptor antagonist is studied * Any condition that in the opinion of the Investigator may interfere with adherence to trial protocol

Treatments Being Tested

DRUG

Spironolactone

Treatment with Spironolactone tablets on top of standard care

OTHER

Standard care

Standard care does not involve Spironolactone

Locations (20)

Trial sites listed on ClinicalTrials.gov for this study. Site activation status can vary — confirm with the specific site before traveling for a screening visit.

Advanced Cardiovascular LLC
Alexander City, Alabama, United States
University of Alabama at Birmingham
Birmingham, Alabama, United States
Banner - University Medical Group
Tucson, Arizona, United States
MedStar Cardiovascular Research Network
Washington D.C., District of Columbia, United States
Howard University Hospital
Washington D.C., District of Columbia, United States
Holy Cross Hospital
Fort Lauderdale, Florida, United States
Piedmont Atlanta Hospital
Atlanta, Georgia, United States
Wellstar Health System, Inc.
Marietta, Georgia, United States
Queens Medical Center
Honolulu, Hawaii, United States
Fox Valley Clinical Research Center, LLC
Aurora, Illinois, United States
University of Illinois at Chicago
Chicago, Illinois, United States
Alexian Brothers Medical Center
Elk Grove Village, Illinois, United States
Methodist Medical Center of Illinois
Peoria, Illinois, United States
St. Vincent Medical Group
Indianapolis, Indiana, United States
Ochsner Medical Center
New Orleans, Louisiana, United States
Shady Grove Adventist Hospital
Rockville, Maryland, United States
Brigham and Women's Hospital
Boston, Massachusetts, United States
Pentucket Medical Associates
Haverhill, Massachusetts, United States
Charles River Medical Associates
Natick, Massachusetts, United States
Newton-Wellesley Hospital
Newton, Massachusetts, United States

How to Talk to Your Doctor About This Trial

Bring the printable summary of this trial — including the NCT ID (NCT02901184), the sponsor (Uppsala University), and the key eligibility criteria — to your next appointment. Your doctor can review the inclusion and exclusion criteria against your medical history, lab values, and current treatments to assess whether you are likely to qualify. They can also help you weigh whether trial participation makes sense alongside your existing care plan.

Useful questions to walk through together: What does the trial protocol require beyond standard care? How long is the active treatment phase, and how long is follow-up? Are there study visits at sites I can reach? Who pays for the trial-specific procedures, and who pays for standard-of-care portions? See our 25 questions to ask about clinical trials guide for a more complete checklist.

Authoritative Sources

The official record for this trial lives on ClinicalTrials.gov — the federal registry maintained by the National Library of Medicine at NIH. For background on how this trial fits into the FDA approval pathway, see the FDA drug approval process. For oncology-specific guidance for patients considering trials, the National Cancer Institute publishes patient-oriented overviews. International trial registries are aggregated by the WHO ICTRP.

Frequently Asked Questions

What is the NCT02901184 clinical trial studying?

Heart failure with preserved ejection fraction (HFPEF) is common and deadly but without therapy. Inconclusive studies such as TOPCAT (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) suggest spironolactone may be effective in HFPEF, but it is generic and will not be studied by industry. SPIRRIT is a unique Registry-Randomized Clinical Trial (RRCT) that will test the hypothesis that spironolactone plus standard of care compared to standard of care alone reduces the composite of CV mortality and HF hospitalization as follows: Population: HFPEF patients in t… The full protocol is registered on ClinicalTrials.gov and includes the primary outcome measures, eligibility criteria, and study endpoints.

Who can participate in NCT02901184?

Eligibility for this trial depends on the specific inclusion and exclusion criteria set by the sponsor. The plain-English summary above translates the most important criteria into accessible language; the official clinical text is preserved in the collapsible section underneath. Whether you fit any specific trial is a medical decision your doctor needs to confirm — bring the trial information to your treating physician for a full review against your medical history.

How do I contact the trial site for NCT02901184?

Contact information registered with ClinicalTrials.gov is shown in the sidebar of this page. Before reaching out, confirm with your treating physician that this trial is appropriate for your situation. The trial site will then walk you through the screening process to determine final eligibility.

Is participating in a clinical trial safe?

Clinical trials in the United States are regulated by the FDA and overseen by Institutional Review Boards (IRBs) that review the protocol for safety. Risk varies by trial — Phase 1 studies test new treatments in humans for the first time, while Phase 3 trials use treatments that have already passed earlier safety screening. The informed consent document for any specific trial details the known risks and what to expect. Discuss those risks with your physician before deciding whether to participate.

Where can I verify the data on this page?

Every detail on this page comes directly from the ClinicalTrials.gov API. Click "View on ClinicalTrials.gov" in the sidebar to see the official, unmodified record. The federal record is always authoritative; this page is a structured presentation with a plain-English eligibility translation. For background on how clinical trials are regulated, see the FDA drug approval process documentation.

How This Page Is Built

Every field on this page is pulled directly from the ClinicalTrials.gov API v2 — no estimates, no proxies. The plain-English eligibility translation is generated from the original protocol text and reviewed for fidelity to the underlying clinical criteria. The original clinical text remains visible in the collapsible section above so users and clinicians can verify the translation. Read the full methodology for the data pipeline and known limitations.

Source: ClinicalTrials.gov API v2 record for NCT02901184. Maintained by the National Library of Medicine at NIH. Public domain. Cite as: "TrialFinderData. NCT02901184. Data: ClinicalTrials.gov."

Medical disclaimer: This page is informational, not medical advice. Talk to your doctor about whether a clinical trial is right for you.

Last updated 2026-05-08 · Data from ClinicalTrials.gov.