Atrial fibrillation (AF) is a common comorbidity in patients with symptomatic heart failure with a preserved ejection fraction.

Spironolactone treatment did not reduce the risk of new-onset AF or recurrence of AF in patients with heart failure and a preserved ejection fraction.

Specifically, in patients with comorbidities related to an increased risk of AF, such as hypertension and obesity, spironolactone did not reduce new-onset AF or recurrence of AF.

These findings are in contrast to previous findings in patients with symptomatic heart failure with a reduced ejection fraction.