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Pfeffer MA. Cardiovasc Drugs Ther. PMID: Similar articles Heart failure with systolic dysfunction complicating acute myocardial infarction - differential outcomes but similar eplerenone efficacy by ST-segment or non-ST-segment elevation: A post hoc substudy of the EPHESUS trial. Carillo S, et al. Arch Cardiovasc Dis. Epub Mar A systematic review and economic evaluation of the clinical effectiveness and cost-effectiveness of aldosterone antagonists for postmyocardial infarction heart failure.

McKenna C, et al. Health Technol Assess. PMID: Review. Eplerenone reduces the risk after infarction]. MMW Fortschr Med. PMID: German. No abstract available. Timing of eplerenone initiation and outcomes in patients with heart failure after acute myocardial infarction complicated by left ventricular systolic dysfunction: insights from the EPHESUS trial. Adamopoulos C, et al. Eur J Heart Fail. Selective aldosterone blockade with eplerenone in patients with congestive heart failure.

Salam AM. Expert Opin Investig Drugs. Show more similar articles See all similar articles. Cited by 55 articles Spironolactone in pulmonary arterial hypertension: results of a cross-over study.

Safdar Z, et al. Pulm Circ. Clinical determinants and prognostic implications of renin and aldosterone in patients with symptomatic heart failure. Kobayashi M, et al. ESC Heart Fail. Snapshot evaluation of acute and chronic heart failure in real-life in Turkey: A follow-up data for mortality. Anatol J Cardiol. Gorini S, et al. Front Endocrinol Lausanne. Ferreira JP, et al. Clin Cardiol.

Epub Sep 3. Clinical Trial. Show more "Cited by" articles See all "Cited by" articles. Double-Blind Method Actions. Eplerenone Actions. Humans Actions. Multicenter Studies as Topic Actions. Randomized Controlled Trials as Topic Actions. Research Design Actions. Sample Size Actions. Survival Analysis Actions. Systole Actions. Substances Mineralocorticoid Receptor Antagonists Actions. Spironolactone Actions.

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Eplerenone Post-AMI Heart Failure Efficacy and Survival Study - EPHESUS

Eplerenone treatment in this setting also significantly reduced mortality from cardiovascular causes and hospitalizations for cardiovascular issues. In summary, the trial demonstrated that treatment with eplerenone days after an acute MI significantly reduced mortality RR 0. While the rates of gynecomastia have been lower with eplerenone as compared with spironolactone, the costs of treatment with eplerenone are considerably higher. Moreover, the RALES trial had demonstrated a much larger relative risk reduction in all-cause mortality with spironolactone, thus, some have suggested that EPHESUS should have been conducted with spironolactone instead. Click to read the study in NEJM.


The EPHESUS trial: Eplerenone in heart failure after myocardial infarction [Classics Series]

La insuficiencia cardiaca es la principal causa de muerte en los pacientes hospitalizados por infarto agudo de miocardio. La eplerenona tiene una eficacia similar a la de espironolotactona, pero con menores tasas de ginecomastia, mastodinia y alteraciones menstruales y de la libido. Heart failure is the main cause of death in patients hospitalized for acute myocardial infarction. Blockade of the renin-angiotensin-aldosterone system with angiotensinconverting enzyme ACE inhibitors and beta-blockers improves the prognosis of postinfarction patients with left ventricular dysfunction. Preliminary experimental findings indicate that aldosterone receptor blockade could also be beneficial in this context. The efficacy of eplerenone is similar to that of spironolactone, but it results in less gynecomastia, mastodynia, and menstrual and libido disturbance.


Treatment with the selective aldosterone receptor blockade eplerenone reduces overall mortality and cardiovascular CV mortality or hospitalization for CV events among patients with AMI complicated by LV dysfunction and heart failure who are receiving optimal medical therapy. Presence of heart failure was not required in diabetic patients. Optimal medical therapy could include angiotensin-converting enzyme ACE inhibitors, angiotensin-receptor blockers, diuretics, and beta-blockers, as well as coronary reperfusion therapy. Fewer deaths occurred in the eplerenone arm compared with the placebo arm The second primary end point, CV deaths or hospitalizations, occurred less frequently in the eplerenone arm Sudden death from cardiac causes occurred less in the eplerenone arm RR 0.

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