POST-2
Prevention of Syncope Trial 2
Doente / População Intervenção / Exposição Comparação Desfecho
In 210 patients with recurrent vasovagal syncope, fludrocortisone did not significantly reduce the first recurrence of syncope over one year compared with placebo, although a benefit emerged once the dose had been stabilised.
N
210
Desenho
Double-blind, placebo-controlled RCT
Desfecho
Time to first recurrence of syncope over 1 year
Relevância
3
ResultadoHR 0.69 (95 % CI 0.46–1.03; p=0.069) — the prespecified 40 % relative risk reduction was not met. Restricted to the period after dose stabilisation, HR 0.51 (95 % CI 0.28–0.89; p=0.019).
Sheldon R, Raj SR, Rose MS, et al. J Am Coll Cardiol. 2016;68(1):1-9. 10.1016/j.jacc.2016.04.030
Discussão e crítica
It formally missed its primary endpoint and the supportive analyses are post hoc, so the effect is fragile. It is nonetheless the largest randomised evidence for fludrocortisone and underpins its class-IIb place in young patients with low blood pressure.