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

Bertram Pitt*, Mihai Gheorghiade, Faiez Zannad, Jeffrey L. Anderson, Dirk J. van Veldhuisen, Alexander Parkhomenko, Ramon Corbalan, Eric Q. Klug, Robin Mukherjee, Henry Solomon

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

Aims: 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 ≤ 30% at baseline was conducted to determine the value of eplerenone in this setting. Methods and results: In EPHESUS, 6632 patients with LVEF ≤ 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 ≤ 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). Conclusions: Treatment with eplerenone plus standard therapy in patients with post-AMI HF and LVEF ≤ 30% provided significant incremental benefits in reducing both early and late mortality and morbidity.

Original languageEnglish (US)
Pages (from-to)295-301
Number of pages7
JournalEuropean Journal of Heart Failure
Volume8
Issue number3
DOIs
StatePublished - May 2006

Keywords

  • Aldosterone
  • EPHESUS
  • Eplerenone
  • Heart failure
  • Left ventricular systolic dysfunction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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