Back to Search
Start Over
Effect of eplerenone in percutaneous coronary intervention-treated post-myocardial infarction patients with left ventricular systolic dysfunction: a subanalysis of the EPHESUS trial
- Source :
- European Journal of Heart Failure, European Journal of Heart Failure, Oxford University Press (OUP), 2014, 16 (6), pp.685-691. ⟨10.1002/ejhf.88⟩
- Publication Year :
- 2014
- Publisher :
- Wiley, 2014.
-
Abstract
- Aims EPHESUS was a multicentre, double-blind clinical trial in which 6632 patients with acute myocardial infarction (AMI) complicated by LV systolic dysfunction (LVSD) were randomized to receive eplerenone (n = 3319) or placebo (n = 3313). A total of 1580 EPHESUS patients were treated with PCI, which is now the standard treatment for AMI. This EPHESUS substudy examined the effects of eplerenone upon cardiovascular outcomes in PCI-treated patients. Methods and results EPHESUS patients were divided into PCI-treated and non-PCI-treated cohorts, and the effect of eplerenone upon mortality and other major adverse cardiovascular outcomes was assessed in each cohort. The PCI-treated patients (n = 1580) were younger, and had better renal function and fewer co-morbidities than non-PCI-treated patients (n = 5052). Cardiovascular mortality was significantly lower in PCI-treated patients as compared with non-PCI-treated patients (7% vs. 16%, P < 0.0001). However, the incidence of non-fatal events was similar in PCI-treated and non-PCI-treated cohorts. There was no statistical difference between the PCI-treated and non-PCI-treated cohorts in the primary or secondary outcomes of the trial. Eplerenone administration, compared with placebo, in the PCI-treated cohort did not affect PCI-related clinical outcomes, including recurrence of angina, the occurrence of acute coronary syndromes, or the need for further revascularization. Conclusions The beneficial effects of eplerenone in the EPHESUS trial exist for both PCI- and non-PCI-treated AMI patients with LVSD. Eplerenone has minimal, if any, effect upon reducing PCI-related adverse events in the PCI-treated cohort.
- Subjects :
- Male
medicine.medical_treatment
MESH: Comorbidity
Comorbidity
Spironolactone
030204 cardiovascular system & hematology
Angina
Ventricular Dysfunction, Left
MESH: Aged, 80 and over
0302 clinical medicine
MESH: Ventricular Dysfunction, Left
MESH: Double-Blind Method
030212 general & internal medicine
Myocardial infarction
Mineralocorticoid Receptor Antagonists
MESH: Treatment Outcome
Aged, 80 and over
MESH: Aged
MESH: Middle Aged
Standard treatment
Middle Aged
3. Good health
Eplerenone
MESH: Myocardial Infarction
Treatment Outcome
surgical procedures, operative
MESH: Spironolactone
Cohort
Cardiology
Female
Cardiology and Cardiovascular Medicine
MESH: Percutaneous Coronary Intervention
therapeutics
medicine.drug
medicine.medical_specialty
Heart failure
MESH: Mineralocorticoid Receptor Antagonists
03 medical and health sciences
Percutaneous Coronary Intervention
Double-Blind Method
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Internal medicine
medicine
Humans
cardiovascular diseases
Aged
MESH: Humans
business.industry
Angioplasty
Percutaneous coronary intervention
medicine.disease
MESH: Male
Clinical trial
Conventional PCI
business
MESH: Female
Subjects
Details
- ISSN :
- 13889842
- Volume :
- 16
- Database :
- OpenAIRE
- Journal :
- European Journal of Heart Failure
- Accession number :
- edsair.doi.dedup.....44d7524729a58c2f054e0af4cb0339e2