title: Aldosterone Antagonists in ST Elevation Myocardial Infarction Patients with Low Left Ventricular Ejection Fraction: a Retrospective Study at Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Nepal.
abstract: BACKGROUND
  Aldosterone antagonists (AA) improve survival in ST elevation myocardial infarction (STEMI) patients with left ventricular ejection fraction(LVEF) "T40% ,with either clinical heart failure or diabetes mellitus. Our aim was to assess the adherence of AA use in Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
  
  
  METHODS
  Medical records of 171 STEMI patients with LVEF "T40% and discharged from our centre between January 2012 and December 2012 were retrospectively reviewed, regarding the use of AA use.
  
  
  RESULTS
  Among the 171 STEMI patients with LVEF "T40%, 5 patients were excluded study due to the presence of contraindication to AA therapy. Among the remaining 166 patients, only 135 (81.2%) patients were eligible for the AA therapy (58 patients with diabetes mellitus and clinical heart failure in 77 patients). Out of 58 diabetes mellitus patients, 28 (48.2%) patients were treated with AA. Whereas 39(50.6%) out of 77 patients with clinical heart failure were treated with AA. Overall, 67(49.6%) patients among 135 eligible patients were treated with AA.
  
  
  CONCLUSIONS
  As in the international studies AA is under-used in our patient population. We still need some more effort to improve our prescription rate.
authors.affiliation: Department of Cardiology, Shahid Gangalal National Heart Centre Bansbari, Kathmandu, Nepal.
authors.forename: Chandra Mani
authors.initials: CM
authors.lastname: Adhikari
authors.affiliation: Department of Cardiology, Shahid Gangalal National Heart Centre Bansbari, Kathmandu, Nepal.
authors.forename: Sujeeb
authors.initials: S
authors.lastname: Rajbhandari
authors.affiliation: Department of Cardiology, Shahid Gangalal National Heart Centre Bansbari, Kathmandu, Nepal.
authors.forename: Dipanker
authors.initials: D
authors.lastname: Prajapati
authors.affiliation: Department of Cardiology, Shahid Gangalal National Heart Centre Bansbari, Kathmandu, Nepal.
authors.forename: Nagma
authors.initials: N
authors.lastname: Shrestha
authors.affiliation: Department of Cardiology, Shahid Gangalal National Heart Centre Bansbari, Kathmandu, Nepal.
authors.forename: Bibek
authors.initials: B
authors.lastname: Baniya
authors.affiliation: Department of Cardiology, Shahid Gangalal National Heart Centre Bansbari, Kathmandu, Nepal.
authors.forename: Amrit
authors.initials: A
authors.lastname: Bogati
authors.affiliation: Department of Cardiology, Shahid Gangalal National Heart Centre Bansbari, Kathmandu, Nepal.
authors.forename: Prakash
authors.initials: P
authors.lastname: Gurung
authors.affiliation: Department of Cardiology, Shahid Gangalal National Heart Centre Bansbari, Kathmandu, Nepal.
authors.forename: Suman
authors.initials: S
authors.lastname: Thapaliya