Heart Care Info - Heart Disease Prevention & Treatment

Determinants and Consequences of Renal Function Variations With Aldosterone Blocker Therapy in Heart Failure Patients After Myocardial InfarctionClinical ...

P Rossignol, JGF Cleland, S Bhandari, S Tala... - Circulation, 2012 - Am Heart Assoc BackgroundWe evaluated the effect of the selective mineralocorticoid receptor antagonist eplerenone on renal function and the interaction between changes in renal function and subsequent cardiovascular outcomes in patients with heart failure and left ventricular ...

Methods and Results—Serial changes in estimated glomerular filtration rate (e GFR) were available in 5792 patients during a 24-month follow-up. Patients assigned to eplerenone had a decline in e GFR with an adjusted mean difference of −1.4±0.3 m L · min−1 · 1.73 m−2 compared with placebo (P20% in the first month, 16.9% and 14.7% in the eplerenone and placebo groups, respectively (odds ratio, 1.15; 95% confidence interval, 1.02–1.30; P=0.017). In multivariate analyses, determinants of this early decline in e GFR were female sex, age ≥65 years, smoking, left ventricular ejection fraction 20% was associated with worse cardiovascular outcomes independently of baseline e GFR and of the use of eplerenone, which retained its prognostic benefits even under these circumstances.