Aldosterone blockade in post-acute myocardial infarction heart failure.
Development of heart failure (HF) or left ventricular systolic dysfunction (LVSD) significantly increases mortality post acute myocardial infarction (AMI). Aldosterone contributes to the development and progression of HF post AMI, and major guidelines now recommend aldosterone blockade in this setting. However, lack of practical experience with aldosterone blockade may make clinicians hesitant to use these therapies. This review is based on a consensus cardiology conference that occurred in May 2005 (New York City) concerning these topics. Potential barriers to the use of aldosterone blockade are discussed and an algorithm for appropriate in-hospital pharmacologic management of AMI with LVSD and/or HF is presented.
Pitt
Bertram
B
University of Michigan Medical Center, William Beaumont Hospital, Cardiovascular Department, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA. bpitt@med.umich.edu
Ferrari
Roberto
R
Gheorghiade
Mihai
M
van Veldhuisen
Dirk J
DJ
Krum
Henry
H
McMurray
John
J
Lopez-Sendon
Jose
J
D000465:Algorithms; D002303:Cardiac Output, Low / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D000077545:Eplerenone; D006801:Humans; D006947:Hyperkalemia / Q000517:prevention & control; D007022:Hypotension / Q000517:prevention & control; D000451:Mineralocorticoid Receptor Antagonists / Q000191:economics / Q000627:therapeutic use*; D009203:Myocardial Infarction / Q000150:complications; D012307:Risk Factors; D013148:Spironolactone / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality
D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D000077545:Eplerenone