Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms.

Faiez Zannad; John J. V. McMurray; Henry Krum; Dirk J. van Veldhuisen; Karl Swedberg; Harry Shi; John Vincent; Stuart J. Pocock; Bertram Pitt; EMPHASIS-HF Study Grp

doi:10.1056/NEJMoa1009492

Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms.

Faiez Zannad^*, John J. V. McMurray, Henry Krum, Dirk J. van Veldhuisen, Karl Swedberg, Harry Shi, John Vincent, Stuart J. Pocock, Bertram Pitt, EMPHASIS-HF Study Grp

^*Corresponding author for this work

Cardiovascular Centre (CVC)

Research output: Contribution to journal › Article › Academic › peer-review

2437 Citations (Scopus)

Abstract

Background: Mineralocorticoid antagonists improve survival among patients with chronic, severe systolic heart failure and heart failure after myocardial infarction. We evaluated the effects of eplerenone in patients with chronic systolic heart failure and mild symptoms.

Methods: In this randomized, double-blind trial, we randomly assigned 2737 patients with New York Heart Association class II heart failure and an ejection fraction of no more than 35% to receive eplerenone (up to 50 mg daily) or placebo, in addition to recommended therapy. The primary outcome was a composite of death from cardiovascular causes or hospitalization for heart failure.

Results: The trial was stopped prematurely, according to prespecified rules, after a median follow-up period of 21 months. The primary outcome occurred in 18.3% of patients in the eplerenone group as compared with 25.9% in the placebo group (hazard ratio, 0.63; 95% confidence interval [CI], 0.54 to 0.74; P

Conclusions: Eplerenone, as compared with placebo, reduced both the risk of death and the risk of hospitalization among patients with systolic heart failure and mild symptoms. (Funded by Pfizer; ClinicalTrials.gov number, NCT00232180.)

N Engl J Med 2011;364:11-21.

Original language	English
Pages (from-to)	11-21
Number of pages	11
Journal	New England Journal of Medicine
Volume	364
Issue number	1
DOIs	https://doi.org/10.1056/NEJMoa1009492
Publication status	Published - 6-Jan-2011

Keywords

LEFT-VENTRICULAR DYSFUNCTION
ACUTE MYOCARDIAL-INFARCTION
MINERALOCORTICOID RECEPTOR
CARDIAC FIBROSIS
TASK-FORCE
ALDOSTERONE
SPIRONOLACTONE
ASSOCIATION
SURVIVAL
TRIAL

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title = "Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms.",

abstract = "Background: Mineralocorticoid antagonists improve survival among patients with chronic, severe systolic heart failure and heart failure after myocardial infarction. We evaluated the effects of eplerenone in patients with chronic systolic heart failure and mild symptoms.Methods: In this randomized, double-blind trial, we randomly assigned 2737 patients with New York Heart Association class II heart failure and an ejection fraction of no more than 35% to receive eplerenone (up to 50 mg daily) or placebo, in addition to recommended therapy. The primary outcome was a composite of death from cardiovascular causes or hospitalization for heart failure.Results: The trial was stopped prematurely, according to prespecified rules, after a median follow-up period of 21 months. The primary outcome occurred in 18.3% of patients in the eplerenone group as compared with 25.9% in the placebo group (hazard ratio, 0.63; 95% confidence interval [CI], 0.54 to 0.74; PConclusions: Eplerenone, as compared with placebo, reduced both the risk of death and the risk of hospitalization among patients with systolic heart failure and mild symptoms. (Funded by Pfizer; ClinicalTrials.gov number, NCT00232180.)N Engl J Med 2011;364:11-21.",

keywords = "LEFT-VENTRICULAR DYSFUNCTION, ACUTE MYOCARDIAL-INFARCTION, MINERALOCORTICOID RECEPTOR, CARDIAC FIBROSIS, TASK-FORCE, ALDOSTERONE, SPIRONOLACTONE, ASSOCIATION, SURVIVAL, TRIAL",

author = "Faiez Zannad and McMurray, {John J. V.} and Henry Krum and {van Veldhuisen}, {Dirk J.} and Karl Swedberg and Harry Shi and John Vincent and Pocock, {Stuart J.} and Bertram Pitt and {EMPHASIS-HF Study Grp}",

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doi = "10.1056/NEJMoa1009492",

language = "English",

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AU - Zannad, Faiez

AU - McMurray, John J. V.

AU - Krum, Henry

AU - van Veldhuisen, Dirk J.

AU - Swedberg, Karl

AU - Shi, Harry

AU - Vincent, John

AU - Pocock, Stuart J.

AU - Pitt, Bertram

AU - EMPHASIS-HF Study Grp

PY - 2011/1/6

Y1 - 2011/1/6

N2 - Background: Mineralocorticoid antagonists improve survival among patients with chronic, severe systolic heart failure and heart failure after myocardial infarction. We evaluated the effects of eplerenone in patients with chronic systolic heart failure and mild symptoms.Methods: In this randomized, double-blind trial, we randomly assigned 2737 patients with New York Heart Association class II heart failure and an ejection fraction of no more than 35% to receive eplerenone (up to 50 mg daily) or placebo, in addition to recommended therapy. The primary outcome was a composite of death from cardiovascular causes or hospitalization for heart failure.Results: The trial was stopped prematurely, according to prespecified rules, after a median follow-up period of 21 months. The primary outcome occurred in 18.3% of patients in the eplerenone group as compared with 25.9% in the placebo group (hazard ratio, 0.63; 95% confidence interval [CI], 0.54 to 0.74; PConclusions: Eplerenone, as compared with placebo, reduced both the risk of death and the risk of hospitalization among patients with systolic heart failure and mild symptoms. (Funded by Pfizer; ClinicalTrials.gov number, NCT00232180.)N Engl J Med 2011;364:11-21.

AB - Background: Mineralocorticoid antagonists improve survival among patients with chronic, severe systolic heart failure and heart failure after myocardial infarction. We evaluated the effects of eplerenone in patients with chronic systolic heart failure and mild symptoms.Methods: In this randomized, double-blind trial, we randomly assigned 2737 patients with New York Heart Association class II heart failure and an ejection fraction of no more than 35% to receive eplerenone (up to 50 mg daily) or placebo, in addition to recommended therapy. The primary outcome was a composite of death from cardiovascular causes or hospitalization for heart failure.Results: The trial was stopped prematurely, according to prespecified rules, after a median follow-up period of 21 months. The primary outcome occurred in 18.3% of patients in the eplerenone group as compared with 25.9% in the placebo group (hazard ratio, 0.63; 95% confidence interval [CI], 0.54 to 0.74; PConclusions: Eplerenone, as compared with placebo, reduced both the risk of death and the risk of hospitalization among patients with systolic heart failure and mild symptoms. (Funded by Pfizer; ClinicalTrials.gov number, NCT00232180.)N Engl J Med 2011;364:11-21.

KW - LEFT-VENTRICULAR DYSFUNCTION

KW - ACUTE MYOCARDIAL-INFARCTION

KW - MINERALOCORTICOID RECEPTOR

KW - CARDIAC FIBROSIS

KW - TASK-FORCE

KW - ALDOSTERONE

KW - SPIRONOLACTONE

KW - ASSOCIATION

KW - SURVIVAL

KW - TRIAL

U2 - 10.1056/NEJMoa1009492

DO - 10.1056/NEJMoa1009492

M3 - Article

SN - 0028-4793

VL - 364

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EP - 21

JO - New England Journal of Medicine

JF - New England Journal of Medicine

IS - 1

ER -

Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms.

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