Tags

Type your tag names separated by a space and hit enter

Update on aldosterone antagonists use in heart failure with reduced left ventricular ejection fraction. Heart Failure Society of America Guidelines Committee.
J Card Fail. 2012 Apr; 18(4):265-81.JC

Abstract

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.

Authors+Show Affiliations

Department of Medicine, Division of Cardiology, Emory University, Atlanta, GA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22464767

Citation

Butler, Javed, et al. "Update On Aldosterone Antagonists Use in Heart Failure With Reduced Left Ventricular Ejection Fraction. Heart Failure Society of America Guidelines Committee." Journal of Cardiac Failure, vol. 18, no. 4, 2012, pp. 265-81.
Butler J, Ezekowitz JA, Collins SP, et al. Update on aldosterone antagonists use in heart failure with reduced left ventricular ejection fraction. Heart Failure Society of America Guidelines Committee. J Card Fail. 2012;18(4):265-81.
Butler, J., Ezekowitz, J. A., Collins, S. P., Givertz, M. M., Teerlink, J. R., Walsh, M. N., Albert, N. M., Westlake Canary, C. A., Carson, P. E., Colvin-Adams, M., Fang, J. C., Hernandez, A. F., Hershberger, R. E., Katz, S. D., Rogers, J. G., Spertus, J. A., Stevenson, W. G., Sweitzer, N. K., Tang, W. H., ... Starling, R. C. (2012). Update on aldosterone antagonists use in heart failure with reduced left ventricular ejection fraction. Heart Failure Society of America Guidelines Committee. Journal of Cardiac Failure, 18(4), 265-81. https://doi.org/10.1016/j.cardfail.2012.02.005
Butler J, et al. Update On Aldosterone Antagonists Use in Heart Failure With Reduced Left Ventricular Ejection Fraction. Heart Failure Society of America Guidelines Committee. J Card Fail. 2012;18(4):265-81. PubMed PMID: 22464767.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Update on aldosterone antagonists use in heart failure with reduced left ventricular ejection fraction. Heart Failure Society of America Guidelines Committee. AU - Butler,Javed, AU - Ezekowitz,Justin A, AU - Collins,Sean P, AU - Givertz,Michael M, AU - Teerlink,John R, AU - Walsh,Mary N, AU - Albert,Nancy M, AU - Westlake Canary,Cheryl A, AU - Carson,Peter E, AU - Colvin-Adams,Monica, AU - Fang,James C, AU - Hernandez,Adrian F, AU - Hershberger,Ray E, AU - Katz,Stuart D, AU - Rogers,Joseph G, AU - Spertus,John A, AU - Stevenson,William G, AU - Sweitzer,Nancy K, AU - Tang,W H Wilson, AU - Stough,Wendy Gattis, AU - Starling,Randall C, PY - 2012/02/12/received PY - 2012/02/15/accepted PY - 2012/4/3/entrez PY - 2012/4/3/pubmed PY - 2012/9/12/medline SP - 265 EP - 81 JF - Journal of cardiac failure JO - J. Card. Fail. VL - 18 IS - 4 N2 - 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. SN - 1532-8414 UR - https://www.unboundmedicine.com/medline/citation/22464767/Update_on_aldosterone_antagonists_use_in_heart_failure_with_reduced_left_ventricular_ejection_fraction__Heart_Failure_Society_of_America_Guidelines_Committee_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1071-9164(12)00076-0 DB - PRIME DP - Unbound Medicine ER -