PMID- 22464767
OWN - NLM
STAT- MEDLINE
DCOM- 20120911
LR  - 20220408
IS  - 1532-8414 (Electronic)
IS  - 1071-9164 (Linking)
VI  - 18
IP  - 4
DP  - 2012 Apr
TI  - Update on aldosterone antagonists use in heart failure with reduced left 
      ventricular ejection fraction. Heart Failure Society of America Guidelines 
      Committee.
PG  - 265-81
LID - 10.1016/j.cardfail.2012.02.005 [doi]
AB  - Aldosterone antagonists (or mineralocorticoid receptor antagonists [MRAs]) are 
      guideline-recommended therapy for patients with moderate to severe heart failure 
      (HF) symptoms and reduced left ventricular ejection fraction (LVEF), and in 
      postmyocardial infarction patients with HF. The Eplerenone in Mild Patients 
      Hospitalization and Survival Study in Heart Failure (EMPHASIS-HF) trial evaluated 
      the MRA eplerenone in patients with mild HF symptoms. Eplerenone reduced the risk 
      of the primary endpoint of cardiovascular death or HF hospitalization (hazard 
      ratio [HR] 0.63, 95% confidence interval [CI] 0.54-0.74, P < .001) and all-cause 
      mortality (adjusted HR 0.76, 95% CI 0.62-0.93, P < .008) after a median of 21 
      months. Based on EMPHASIS-HF, an MRA is recommended for patients with New York 
      Heart Association (NYHA) Class II-IV symptoms and reduced LVEF (<35%) on standard 
      therapy (Strength of Evidence A). Patients with NYHA Class II symptoms should 
      have another high-risk feature to be consistent with the EMPHASIS-HF population 
      (age >55 years, QRS duration >130 msec [if LVEF between 31% and 35%], HF 
      hospitalization within 6 months or elevated B-type natriuretic peptide level). 
      Renal function and serum potassium should be closely monitored. Dose selection 
      should consider renal function, baseline potassium, and concomitant drug 
      interactions. The efficacy of eplerenone in patients with mild HF symptoms 
      translates into a unique opportunity to reduce morbidity and mortality earlier in 
      the course of the disease.
CI  - Copyright (c) 2012 Elsevier Inc. All rights reserved.
FAU - Butler, Javed
AU  - Butler J
AD  - Department of Medicine, Division of Cardiology, Emory University, Atlanta, GA, 
      USA.
FAU - Ezekowitz, Justin A
AU  - Ezekowitz JA
FAU - Collins, Sean P
AU  - Collins SP
FAU - Givertz, Michael M
AU  - Givertz MM
FAU - Teerlink, John R
AU  - Teerlink JR
FAU - Walsh, Mary N
AU  - Walsh MN
FAU - Albert, Nancy M
AU  - Albert NM
FAU - Westlake Canary, Cheryl A
AU  - Westlake Canary CA
FAU - Carson, Peter E
AU  - Carson PE
FAU - Colvin-Adams, Monica
AU  - Colvin-Adams M
FAU - Fang, James C
AU  - Fang JC
FAU - Hernandez, Adrian F
AU  - Hernandez AF
FAU - Hershberger, Ray E
AU  - Hershberger RE
FAU - Katz, Stuart D
AU  - Katz SD
FAU - Rogers, Joseph G
AU  - Rogers JG
FAU - Spertus, John A
AU  - Spertus JA
FAU - Stevenson, William G
AU  - Stevenson WG
FAU - Sweitzer, Nancy K
AU  - Sweitzer NK
FAU - Tang, W H Wilson
AU  - Tang WH
FAU - Stough, Wendy Gattis
AU  - Stough WG
FAU - Starling, Randall C
AU  - Starling RC
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Mineralocorticoid Receptor Antagonists)
RN  - 27O7W4T232 (Spironolactone)
RN  - 4964P6T9RB (Aldosterone)
RN  - 6995V82D0B (Eplerenone)
SB  - IM
MH  - Aldosterone/physiology
MH  - Angiotensin-Converting Enzyme Inhibitors/therapeutic use
MH  - Animals
MH  - Eplerenone
MH  - Heart/drug effects
MH  - Heart Failure/complications/*drug therapy/epidemiology/physiopathology
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Kidney/drug effects/physiology
MH  - Mineralocorticoid Receptor Antagonists/pharmacology/*therapeutic use
MH  - Myocardial Infarction/complications
MH  - Randomized Controlled Trials as Topic
MH  - Spironolactone/analogs & derivatives/pharmacology/therapeutic use
MH  - *Stroke Volume
MH  - Ventricular Dysfunction, Left/*drug therapy
EDAT- 2012/04/03 06:00
MHDA- 2012/09/12 06:00
CRDT- 2012/04/03 06:00
PHST- 2012/02/12 00:00 [received]
PHST- 2012/02/15 00:00 [accepted]
PHST- 2012/04/03 06:00 [entrez]
PHST- 2012/04/03 06:00 [pubmed]
PHST- 2012/09/12 06:00 [medline]
AID - S1071-9164(12)00076-0 [pii]
AID - 10.1016/j.cardfail.2012.02.005 [doi]
PST - ppublish
SO  - J Card Fail. 2012 Apr;18(4):265-81. doi: 10.1016/j.cardfail.2012.02.005.