Evaluation of eplerenone in the subgroup of EPHESUS patients with baseline left ventricular ejection fraction <or=30%

European Journal of Heart Failure
Bertram PittEPHESUS Investigators

Abstract

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 <or=30% at baseline was conducted to determine the value of eplerenone in this setting. In EPHESUS, 6,632 patients with LVEF <or=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 <or=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/HF 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). Treatment with eplerenone plus stan...Continue Reading

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Citations

Apr 22, 2009·Expert Opinion on Drug Metabolism & Toxicology·James A MuldowneyCassandra D Benge
Nov 16, 2007·Expert Opinion on Pharmacotherapy·Jacob George, Allan D Struthers
Jan 15, 2016·Heart Failure Reviews·Muthiah VaduganathanJaved Butler
May 16, 2006·The American Journal of Cardiology·Barry GreenbergBertram Pitt
Jan 5, 2017·The New England Journal of Medicine·Lars KøberSteen Pehrson
Dec 22, 2017·European Journal of Heart Failure·Sean D PokorneyRobert J Mentz
Dec 14, 2017·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Demosthenes G KatritsisGerhard Hindricks
Jan 31, 2007·Clinical Cardiology·Rishi SukhijaJawahar L Mehta
Feb 27, 2019·Current Pharmaceutical Design·Vasilios PapademetriouKonstantinos Stavropoulos
May 31, 2019·Heart Failure Reviews·Antonis S ManolisHelen Melita
Jan 7, 2017·The New England Journal of Medicine·Christian KnackstedtHans-Peter Brunner-La Rocca
Aug 29, 2007·Heart Failure Clinics·Martin CadeirasMario C Deng

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