Role of aldosterone blockade for treatment of heart failure and post-acute myocardial infarction.
Heart failure continues to significantly impact morbidity and mortality after acute myocardial infarction (AMI), especially when associated with left ventricular systolic dysfunction (LVSD). Therefore, routine use of optimal therapy for patients with heart failure after AMI is needed in the future. Data from the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS) has demonstrated that addition of eplerenone to standard therapy in patients with LVSD and clinical heart failure post-AMI significantly improves outcomes in these patients, providing the basis for acceptance of aldosterone blockade as an integral component of therapy. However, further studies are needed to more broadly explore the usefulness of aldosterone blockade in heart failure therapy. As research clarifies the many complex pathophysiologic processes involved in post-AMI remodeling, treatment should continue to move beyond symptom-targeted therapies to disease- and mechanism-targeted therapies that will further improve outcomes in the setting of heart failure post-AMI and beyond.
Greenberg
Barry
B
Department of Medicine, University of California-San Diego, San Diego, California 92103, USA, and Division of Tehrapeutics, Clinical Investigation Center INSERM-CHU de Nancy Hôpital Jeanne d'Arc, Donmartin-les Toul, France. bgreenberg@ucsd.edu
Zannad
Faiez
F
Pitt
Bertram
B
D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D009203:Myocardial Infarction / Q000150:complications*; D016896:Treatment Outcome
D000451:Mineralocorticoid Receptor Antagonists