1. Impact of eplerenone on cardiovascular outcomes in heart failure patients with hypokalaemia
- Author
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Rossignol, Patrick, Girerd, Nicolas, Bakris, George, Vardeny, Orly, Claggett, Brian, McMurray, John J. V., Swedberg, Karl, Krum, Henry, van Veldhuisen, Dirk J., Shi, Harry, Spanyers, Sean, Vincent, John, Fay, Renaud, Lamiral, Zohra, Solomon, Scott D., Zannad, Faiez, Pitt, Bertram, and Cardiovascular Centre (CVC)
- Subjects
CHRONIC KIDNEY-DISEASE ,MORTALITY ,nutritional and metabolic diseases ,Heart failure ,Prognosis ,WORSENING RENAL-FUNCTION ,LOW SERUM POTASSIUM ,EMPHASIS-HF ,HYPERKALEMIA ,Eplerenone ,MILD PATIENTS HOSPITALIZATION ,BENEFITS ,Potassium ,SURVIVAL ,MINERALOCORTICOID RECEPTOR ANTAGONIST ,hormones, hormone substitutes, and hormone antagonists - Abstract
AimsAlthough hypokalaemia is common among patients with heart failure (HF), the prognostic significance of baseline hypokalaemia and hypokalaemia during follow-up in HF patients receiving a mineralocorticoid receptor antagonist (MRA) remains uncertain. Methods and resultsResults of the EMPHASIS-HF trial in patients (n = 2737) with HF and reduced EF with mild symptoms, randomized to eplerenone or placebo, were analysed with regard to the presence or occurrence of hypokalaemia (serum K+ 4.0 mmol/L at 1 month after randomization mediated 26.0% (0.6-51.4%) of the eplerenone treatment effect (P = 0.04). ConclusionIn HF patients receiving optimal therapy but not treated with eplerenone, baseline hypokalaemia was associated with worse outcomes. Conversely, hypokalaemia amplified the treatment effect of eplerenone.
- Published
- 2017