Evaluation of eplerenone in the subgroup of EPHESUS patients with baseline left ventricular ejection fraction ?30% Beurteilung der wirkung von eplerenon in der subgruppe der EPHESUS-patienten mit einer linksventrikulären auswurffraktion ?30% zu studienbeginn

Pitt, B; Gheorghiade, M; Zannad, F; Anderson J.L.; Van Veldhuisen D.J.; PARKHOMENKO A.; Corbalan, R; Klug E.Q.; Mukherjee R.; Solomon, H


Aims: Because of the prognostic importance of LV dysfunction following an AMI and the increasing use of electrical and/or mechanical interventions in patients with LV systolic dysfunction, this retrospective analysis of EPHESUS patients with LVEF ?30% at baseline was conducted to determine the value of eplerenone in this setting. Methods and results: In EPHESUS, 6632 patients with LVEF ?40% and clinical heart failure (HF) post-AMI who were receiving standard therapy were randomized to eplerenone 25 mg/day titrated to 50 mg/day or placebo for a mean follow-up of 16 months. Treatment with eplerenone in the subgroup of patients with LVEF ?30% (n=2106) resulted in relative risk reductions of 21% versus placebo in both all-cause mortality (p=0.012) and cardiovascular (CV) mortality/CV hospitalization (p=0.001), and 23% for CV mortality (p=0.008). The relative risk of sudden cardiac death (SCD) was reduced 33% (p=0.01) and HF mortality/HP hospitalization was reduced 25% (p=0.005) with eplerenone compared with placebo. Within 30 days of randomization, eplerenone resulted in relative risk reductions of 43% for all-cause mortality (p=0.002), 29% for CV mortality/CV hospitalization (p=0.006), and 58% for SCD (p=0.008). Conclusions: Treatment with eplerenone plus standard therapy in patients with post-AMI HF and LVEF ?30% provided significant incremental benefits in reducing both early and late mortality and morbidity. © Verlag Perfusion GmbH.

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Título de la Revista: Perfusion
Volumen: 19
Número: 7-8
Fecha de publicación: 2006
Página de inicio: 261
Página final: 268
URL: http://www.scopus.com/inward/record.url?eid=2-s2.0-33750109560&partnerID=q2rCbXpz