However, in Russia and Georgia, prior hospitalization was not linked to increased risk of death or the primary outcome, though it was associated with more HF hospitalizations, likely because no adjudicated HF events occurred in the BNP group in that region. Even though spironolactone reduces cardiovascular events and improves specific events, its effectiveness is unclear due to the variability in the treatment response and the absence of long-term data. Here, NPPB is linked to hydrops fetalis.