RALES Score (Spironolactone Benefit Predictor)
: Explanation and Clinical Context The RALES Score is a clinical tool designed to estimate the survival benefit and safety of spironolactone therapy in patients with advanced heart failure (NYHA class III–IV) and reduced ejection fraction. It is conceptually derived from the Randomized Aldactone Evaluation Study (RALES), published in the New England Journal of Medicine in 1999. The RALES trial demonstrated that addin