Safety and Efficacy of Eplerenone in Patients at High Risk for Hyperkalemia and/or Worsening Renal Function Analyses of the EMPHASIS-HF Study Subgroups (Eplerenone in Mild Patients Hospitalization And SurvIval Study in Heart Failure)

Romain Eschalier, John J. V. McMurray, Karl Swedberg, Dirk J. van Veldhuisen, Henry Krum, Stuart J. Pocock, Harry Shi, John Vincent, Patrick Rossignol, Faiez Zannad*, Bertram Pitt, EMPHASIS-HF Invest

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

158 Citaten (Scopus)


Objectives The study sought to investigate the safety and efficacy of eplerenone in patients at high risk for hyperkalemia or worsening renal function (WRF) in EMPHASIS-HF, a trial that enrolled patients at least 55 years old with heart failure and reduced ejection fraction (HF-REF), in New York Heart Association (NYHA) functional class II and with an estimated glomerular filtration rate (eGFR) >30 ml/min/1.73 m(2) and serum potassium

Background Underuse of eplerenone in patients with HF-REF may be due to fear of inducing hyperkalemia or WRF in high-risk patients.

Methods This was a pre-specified analysis of subgroups of patients at high risk of hyperkalemia or WRF (patients >= 75 years of age, with diabetes, with eGFR 5.5, >6.0, and

Results In all high-risk subgroups, patients treated with eplerenone had an increased risk of potassium >5.5 mmol/l but not of potassium >6.0 mmol/l, and of hospitalization for hyperkalemia or discontinuation of study medication due to adverse events. Eplerenone was effective in reducing the primary composite endpoint in all subgroups.

Conclusions In patients with chronic HF-REF, in NYHA functional class II, and meeting specific inclusion and exclusion criteria, including an eGFR >30 ml/min/1.73 m(2) and potassium

Originele taal-2English
Pagina's (van-tot)1585-1593
Aantal pagina's9
TijdschriftJournal of the American College of Cardiology
Nummer van het tijdschrift17
StatusPublished - 22-okt-2013

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