30
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Eplerenone in chronic heart failure with depressed systolic function.

      Read this article at

      ScienceOpenPublisherPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Eplerenone is a selective mineralocorticoid receptor antagonist that has been recently included in the treatment of patients with chronic heart failure (CHF) and reduced systolic function. This brief review aims to summarize current evidence on the role of eplerenone in the therapy of patients with CHF. In the EPHESUS trial, 6632 post-myocardial infarction patients with ejection fraction (EF) <40% and clinical HF signs were randomized to eplerenone or placebo added to standard therapy 3 to 14 days after the event. After a 16 month follow-up period, eplerenone given early (<7 days) reduced the primary endpoints of all-cause mortality by 15% and cardiovascular death or cardiovascular hospitalization by 13%. In the subsequent EMPHASIS-HF trial, the efficacy and tolerability of eplerenone were tested in patients with mild CHF (NYHA functional class II) and EF ≤ 30% or between 30 and 35% with QRS duration >130 ms. After a median follow-up of 21 months eplerenone significantly reduced (by 37%) the primary composite outcome of risk of death from CV causes and first hospitalization for HF. Based on the above findings, the addition of eplerenone to standard therapy, at doses to be titrated from 25 to 50mg per day, is currently recommended in CHF patients with functional classes II to IV closely resembling those enrolled in these large clinical trials, with adequate monitoring for side effects (mainly hyperkalemia and renal failure). Whether the same beneficial effects of eplerenone extend to CHF patients with mild symptoms and no additional risk factors are unknown.

          Related collections

          Author and article information

          Journal
          Int. J. Cardiol.
          International journal of cardiology
          1874-1754
          0167-5273
          Dec 1 2015
          : 200
          Affiliations
          [1 ] Dipartimento di Scienze Mediche, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Pisana, Italy. Electronic address: maurizio.volterrani@sanraffaele.it.
          [2 ] Dipartimento di Scienze Mediche, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Pisana, Italy; Dipartimento Medicina dei Sistemi, Università Tor Vergata, Rome, Italy.
          Article
          S0167-5273(15)01189-4
          10.1016/j.ijcard.2015.05.126
          26044084
          56fc7316-4525-412e-bb2c-f30d787e7661
          Copyright © 2015. Published by Elsevier Ireland Ltd.
          History

          Chronic heart failure,Clinical trials,Eplerenone,Systolic function

          Comments

          Comment on this article