Journal ArticleDOI
Eplerenone, a Selective Aldosterone Blocker, in Patients with Left Ventricular Dysfunction after Myocardial Infarction
Bertram Pitt,Willem J. Remme,Faiez Zannad,James D. Neaton,Felipe Martinez,Barbara Roniker,Richard Bittman,Steve Hurley,Jay H. Kleiman,Marjorie Gatlin +9 more
Reads0
Chats0
TLDR
The addition of eplerenone to optimal medical therapy reduces morbidity and mortality among patients with acute myocardial infarction complicated by left ventricular dysfunction and heart failure.Abstract:
background Aldosterone blockade reduces mortality and morbidity among patients with severe heart failure. We conducted a double-blind, placebo-controlled study evaluating the effect of eplerenone, a selective aldosterone blocker, on morbidity and mortality among patients with acute myocardial infarction complicated by left ventricular dysfunction and heart failure. methods Patients were randomly assigned to eplerenone (25 mg per day initially, titrated to a maximum of 50 mg per day; 3313 patients) or placebo (3319 patients) in addition to optimal medical therapy. The study continued until 1012 deaths occurred. The primary end points were death from any cause and death from cardiovascular causes or hospitalization for heart failure, acute myocardial infarction, stroke, or ventricular arrhythmia. results During a mean follow-up of 16 months, there were 478 deaths in the eplerenone group and 554 deaths in the placebo group (relative risk, 0.85; 95 percent confidence interval, 0.75 to 0.96; P=0.008). Of these deaths, 407 in the eplerenone group and 483 in the placebo group were attributed to cardiovascular causes (relative risk, 0.83; 95 percent confidence interval, 0.72 to 0.94; P = 0.005). The rate of the other primary end point, death from cardiovascular causes or hospitalization for cardiovascular events, was reduced by eplerenone (relative risk, 0.87; 95 percent confidence interval, 0.79 to 0.95; P=0.002), as was the secondary end point of death from any cause or any hospitalization (relative risk, 0.92; 95 percent confidence interval, 0.86 to 0.98; P=0.02). There was also a reduction in the rate of sudden death from cardiac causes (relative risk, 0.79; 95 percent confidence interval, 0.64 to 0.97; P=0.03). The rate of serious hyperkalemia was 5.5 percent in the eplerenone group and 3.9 percent in the placebo group (P = 0.002), whereas the rate of hypokalemia was 8.4 percent in the eplerenone group and 13.1 percent in the placebo group (P<0.001). conclusions The addition of eplerenone to optimal medical therapy reduces morbidity and mortality among patients with acute myocardial infarction complicated by left ventricular dysfunction and heart failure.read more
Citations
More filters
Journal ArticleDOI
Prophylactic Defibrillator Implantation in Patients with Nonischemic Dilated Cardiomyopathy
Alan H. Kadish,Alan R. Dyer,James P. Daubert,Rebecca Quigg,N.A. Mark Estes,Kelley P. Anderson,Hugh Calkins,David H Hoch,Jeffrey J. Goldberger,Alaa Shalaby,William E. Sanders,Andi Schaechter,Joseph H. Levine +12 more
TL;DR: In patients with severe, nonischemic dilated cardiomyopathy who were treated with ACE inhibitors and beta-blockers, the implantation of a cardioverter-defibrillator significantly reduced the risk of sudden death from arrhythmia and was associated with a nonsignificant reduction in the riskof death from any cause.
Journal ArticleDOI
ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death)
Douglas P. Zipes,A. John Camm,Martin Borggrefe,Alfred E. Buxton,Bernard R. Chaitman,Martin Fromer,Gabriel Gregoratos,George Klein,Arthur J. Moss,Robert J. Myerburg,Silvia G. Priori,Miguel A. Quinones,Dan M. Roden,Michael J. Silka,Cynthia M. Tracy +14 more
TL;DR: In this article, the medical profession plays a significant role in critically evaluating the use of diagnostic procedures and therapies as they are introduced and tested in the detection, management, or prevention of disease states.
Journal ArticleDOI
AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2011 Update A Guideline From the American Heart Association and American College of Cardiology Foundation
Sidney C. Smith,Emelia J. Benjamin,Robert O. Bonow,Lynne T. Braun,Mark A. Creager,Barry A. Franklin,Raymond J. Gibbons,Scott M. Grundy,Loren F. Hiratzka,Daniel W. Jones,Donald M. Lloyd-Jones,Margo Minissian,Lori Mosca,Eric D. Peterson,Ralph L. Sacco,John A. Spertus,James H. Stein,Kathryn A. Taubert +17 more
TL;DR: The development of the present guideline involved a process of partial adaptation of other guideline statements and reports and supplemental literature searches, which confirmed that in patients with atherosclerotic vascular disease, comprehensive risk factor management reduces risk as assessed by a variety of outcomes.
Journal ArticleDOI
The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline
John W. Funder,Robert M. Carey,Franco Mantero,M. Hassan Murad,Martin Reincke,Hirotaka Shibata,Michael Stowasser,William F. Young +7 more
TL;DR: This guideline recommends that all patients with primary aldosteronism undergo adrenal computed tomography as the initial study in subtype testing and to exclude adrenocortical carcinoma and advises that an experienced radiologist should establish/exclude unilateral primary aldehydes using bilateral adrenal venous sampling.
Journal ArticleDOI
2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
Patrick T. O'Gara,Frederick G. Kushner,Deborah D. Ascheim,Donald E. Casey,Mina K. Chung,James A. de Lemos,Steven M. Ettinger,James C. Fang,Francis M. Fesmire,Barry A. Franklin,Christopher B. Granger,Harlan M. Krumholz,Jane A. Linderbaum,David A. Morrow,L. Kristin Newby,Joseph P. Ornato,Narith N. Ou,Martha J. Radford,Jacqueline E. Tamis-Holland,Carl L. Tommaso,Cynthia M. Tracy,Y. Joseph Woo,David Zhao +22 more
TL;DR: The 2017-18 FAHA/FACC/FAHA Education and Research Grants will be focused on advancing the profession’s understanding of central nervous system disorders and the management of post-traumatic stress disorder.
References
More filters
Journal ArticleDOI
Prediction of Creatinine Clearance from Serum Creatinine
Donald W. Cockcroft,M H Gault +1 more
TL;DR: A formula has been developed to predict Creatinine clearance from serum creatinine (Scr) in adult males: Ccr = (140 – age) (wt kg)/72 × Scr (mg/100ml) (15% less i).
Journal ArticleDOI
The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators.
Bertram Pitt,Faiez Zannad,Willem J. Remme,Robert J. Cody,Alain Castaigne,Alfonso Perez,Jolie Palensky,Janet Wittes +7 more
TL;DR: Blockade of aldosterone receptors by spironolactone, in addition to standard therapy, substantially reduces the risk of both morbidity and death among patients with severe heart failure.
Journal ArticleDOI
The Effect of Spironolactone on Morbidity and Mortality in Patients with Severe Heart Failure
Bertram Pitt,Faiez Zannad,Willem J. Remme,Robert J. Cody,Alain Castaigne,Alfonso Perez,Jolie Palensky,Janet Wittes +7 more
The effect of spironolactone on morbidity and mortality in patients with severe heart failure
B Ertram P Itt,F Aiez Z Annad,J. R Emme,R Obert C Ody,A Lain C Astaigne,A Lfonso P Erez,J Olie P Alensky,J Anet W Ittes +7 more
Journal ArticleDOI
Effect of carvedilol on outcome after myocardial infarction in patients with left-ventricular dysfunction: the CAPRICORN randomised trial.
TL;DR: In patients treated long-term after an acute myocardial infarction complicated by left-ventricular systolic dysfunction, carvedilol reduced the frequency of all-cause and cardiovascular mortality, and recurrent, non-fatal myocardia infarctions.
Related Papers (5)
Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. results of the survival and ventricular enlargement trial
Marc A. Pfeffer,Eugene Braunwald,Lemuel A. Moyé,Lofty L. Basta,Edward J. Brown,Thomas E. Cuddy,Barry R. Davis,Edward M. Geltman,Steven Goldman,Greg C. Flaker,Marc Klein,Gervasio A. Lamas,Milton Packer,Jacques R. Rouleau,Jean L. Rouleau,John D. Rutherford,John H. Wertheimer,C. Morton Hawkins +17 more
Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF)
Åke Hjalmarson,Sidney Goldstein,Björn Fagerberg,Hans Wedel,Finn Waagstein,John Kjekshus,John Wikstrand,G. Westergren,M. Thimell,D. El Allaf,Jiri Vitovec,J. Aldershvile,M. Halinen,Rainer Dietz,K. L. Neuhaus,András Jánosi,Gudmundur Thorgeirsson,P. Dunselman,Lars Gullestad,J. Kuch,Johan Herlitz,Peter Rickenbacher,Stephen G. Ball,Stephen S. Gottlieb,Prakash Deedwania,G. Vandenhoven,I. Nováková,S. Danker,M. Lundström,W. Meyer-Sabellek,I. Balla,M. Sveinsdottir,B. Dorhout,A. Hildebrandt,I. Szczurko,C. Larsson,E. Bucher,E. Scott,D. Dwyer,D. G. Julian,David L. DeMets,K. Chatterjee,J. Feyzi,S. Lehto,P. Karpati,W. Motz,O. Samuelsson,J. W. Viersma,B. Andersson,C. Berthe,J. M. Boutefeu,G. Boxho,P. Decroly,J. P. Derbaudrenghien,J. Pirlet,Philip D. Henry,G. Heyndrickx,L. Missault,M. Nannan,P. Timmermans,J. L. Vachiery,W. Van Mieghem,J. L. Vandenbossche,K. Dvorák,M. Herold,Jaromír Hradec,A. Kána,P. Petr,J. Rybka,J. Smíd,P. Svítil,J. Toman,E. Agner,O. Amtorp,K. Egstrup,P. Eliasen,C. O. Gotzsche,P. Hildebrandt,A. Johannesen,P. Kaiser-Nielsen,H. Nielsen,P. E. Nielsen,F. Pedersen,J. Rokkedal Nielsen,K. Skagen,T. Honkanen,E. Hussi,J. Juvonen,H. Jääskeläinen,J. Rinne,T. Salonen,D. Andresen,H. Berwing,Bethge,Beythien,Bischoff,Bundschu,Daniel,Darius,Delius,Drude,Dingerkus,Dück,Eichler,Fach,A. Förster,Girth,Goss,Hahn,Hambrecht,G. F. Hauf,Heinemann,Hepp,Janka,Klocke,Konz,B. Krosse,Kühlkamp,Lewek,B. Lüderitz,Löbe,Maier,Melchior,Müller,Mäurer,Nast,Neuhaus,Obst,Odemar,K. E. von Olshausen,Pomykaj,K. J.G. Schmailzl,Schrader,Schröder,P. L. Schwimmbeck,M. Sigmund,Simon,Strasser,Thilo,Vöhringer,H. Völler,Weibrodt,Wirtz,István Czuriga,M. Hetey,A. Katona,M. Lengyel,A. Nyárádi,A. Rednik,K. Sándori,P. Szabó,J. Tarján,J. Tenczer,S. Timar,P. Vályi,G. Veress,K. Zámolyi,B. Oze,Ge Thorgeirsson,Gu Thorgeirsson,P. J.L.M. Bernink,A. C. Bredero,R. Breedveld,P. N.W.M. Breuls,J. J.J. Bucx,Jan H. Cornel,P. A. de Milliano,Peter H.J.M. Dunselman,B. J.B. Hamer,N. Holwerda,J. Hoogsteen,J. C.A. Hoorntje,Johannes A. Kragten,A. H. Liem,G. Linssen,H. R. Michels,A. R. Ramdat Misier,H. J. Schaafsma,P. Sijbring,R. J.T. Taverne,L. H.J. Van Kempen,R. Van Stralen,P. J. Van Veldhuisen,M. J. Veerhoek,C. J.P.J. Werter,J. C.L. Wesdorp,A. R. Willems,A. J.A.M. Withagen,P. A.G. Zwart,R. Bjornerheim,M. Dahle,Kenneth Dickstein,G. S. Froland,T. Gundersen,K. Hofsoy,T. L. Hole,T. Johansen,J. Mannsverk,P. Nesje,T. M. Omland,C. Sjödin,Peter K. Smith,H. A. Tjonndal,O. Vikesdal,K. Waage,Adamus,K. Jaworska,P. Kolodziej,Z. Kornacewicz-Jach,M. Krzemiñska-Pakula,J. W. Piotrowski,W. Piwowarska,A. Stogowski,J. Wodniecki,K. Wrabec,P. Ahlström,S. Ekdahl,L. O. Hemmingson,L. Holmberg,B. Lernfelt,H. Nilsson B Widgren,K. Ångman,P. Erne,P. Mohacsi,R. Polikar,H. Schläpfer,P. Batin,K. E. Berkin,T. S. Callaghan,J. Forfar,Michael P. Frenneaux,R A Greenbaum,M. Maltz,D. Murdoch,G. Reynolds,J. Stephens,Allan D. Struthers,J. Swan,G. Tildesley,A. Abbasi,P. Alagona,J. Alderman,M. Alipour,J. L. Anderson,Z. Ansari,M. Ashraf,B. T. Beanblossom,S. Bennett,D. Benvenuti,Martin R. Berk,R. Bhalla,Seth Bilazarian,K. F. Browne,C. MBuchter,R. Carlson,C. J. Carlson,K. Danisa,Ira Dauber,Marcus A. Dewood,G. Dennish,D. M. Denny,R. DiBianco,P. M. Diller,Mark E. Dunlap,K. Dowd,A. Edmiston,M. El Shahawy,Uri Elkayam,J. Farnham,P. Fenster,S. Friedman,T. Heywood,J. P. Galichia,Michael R. Geller,Jalal K. Ghali,Mihai Gheorghiade,T. Giles,R. Gillespe,G. Goldberg,M. C. Goldberg,D. A. Goldscher,G. P. Gooden,M. Goodman,L. Goodman,J. Gorwit,Shmuel Gottlieb,A. Gradman,D. Grech,T. Hack,J. H. Hall,M. T. Hattenhauer,M. B. Higginbotham,S. Hutchins,M. Imburgia,B. J. Iteld,B. Jackson,S. Jafri,W. Jauch,S. Jennison,B. H. Kahn,W. Kao,K. Kaplan,Ronald P. Karlsberg,Harold L. Kennedy,J. J. Kennedy,L. Kirkegaard,D. H. Kraus,K. LaBresh,L. Lalonde,M. F. Lesser,R. Levites,M. Levy,R. K. Lewis,Irving K. Loh,H. Madyoon,F. Maislos,Douglas L. Mann,G. L. Maurice,A. Nisar,W. Old,J. D. Pappas,K. Phadke,S. Promisloff,A. M. Rashkow,B. Reeves,J. H. Rosen,M. Rotman,T. Saleem,S. V. Savran,R. Shah,Y. Shalev,J. Shanes,M. O'Shaughnessy,B. Silverman,Richard M. Steingart,L. Swenson,K. Syed,U. Thadani,R. D. Thorsen,M. J. Tonkon,R. Touchon,G. Uhl,K. J. Vaska,S. G. Wagner,C. J. Weaver,Robert J. Weiss,W. J. Wickemeyer,H. J. Willens,J. R. Wilson,R. Wright,L. Yellen +350 more