Spironolactone Use and Higher Hospital Readmission for Medicare Beneficiaries with Heart Failure, Left Ventricular Ejection Fraction <45% and Estimated Glomerular Filtration Rate <45 ml/min/1.73m2

While randomized controlled trials have demonstrated benefits of aldosterone antagonists for patients with heart failure and reduced ejection fraction (HFrEF), they excluded patients with serum creatinine >2.5mg/dl and their use is contraindicated in those with advanced chronic kidney disease (CKD). In the current analysis, we examined the association of spironolactone use with readmission in hospitalized Medicare beneficiaries with HFrEF and advanced CKD. Of the 1140 patients with HFrEF (EF