History of hypertension and eplerenone in patients with acute myocardial infarction complicated by heart failure

• Type: Article in International Scientific Journal
• Date: 2008

Authors

Pitt, B (Author) Other; Ahmed, A (Author) Other; Love, TE (Author) Other; Krum, H (Author) Other; Nicolau, J (Author) Other; Silva Cardoso, J (Author) FMUP; Parkhomenko, A (Author) Other; Aschermann, M (Author) Other; Corbalan, R (Author) Other; Solomon, H (Author) Other; Shi, H (Author) Other; Zannad, F (Author) Other

Journal

Title: Hypertension

Vol. 52

Pages: 271-278

ISSN: 0194-911X

Publisher: Wolters Kluwer Health

Indexing

ISI Web of Knowledge - 21 Citations

Scopus - 18 Citations

Other information

Authenticus ID: P-003-XA5

DOI: 10.1161/hypertensionaha.107.109314

Abstract (EN): In the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study ( n = 6632), eplerenone- associated reduction in all- cause mortality was significantly greater in those with a history of hypertension ( Hx- HTN). There were 4007 patients with Hx- HTN ( eplerenone: n = 1983) and 2625 patients without Hx- HTN ( eplerenone: n = 1336). Propensity scores for eplerenone use, separately calculated for patients with and without Hx- HTN, were used to assemble matched cohorts of 1838 and 1176 pairs of patients. In patients with Hx- HTN, all- cause mortality occurred in 18% of patients treated with placebo ( rate, 1430/ 10 000 person- years) and 14% of patients treated with eplerenone ( rate, 1058/ 10 000 person- years) during 2350 and 2457 years of follow- up, respectively ( hazard ratio [ HR]: 0.71; 95% CI: 0.59 to 0.85; P < 0.0001). Composite end point of cardiovascular hospitalization or cardiovascular mortality occurred in 33% of placebo-treated patients ( 3029/ 10 000 person- years) and 28% of eplerenone- treated patients (2438/10 000 person- years) with Hx- HTN ( HR: 0.82; 95% CI: 0.72 to 0.94; P = 0.003). In patients without Hx- HTN, eplerenone reduced heart failure hospitalization ( HR: 73; 95% CI: 0.55 to 0.97; P = 0.028) but had no effect on mortality ( HR: 0.91; 95% CI: 0.72 to 1.15; P = 0.435) or on the composite end point ( HR: 0.91; 95% CI: 0.76 to 1.10; P = 0.331). Eplerenone should, therefore, be prescribed to all of the post - acute myocardial infarction patients with reduced left ventricular ejection fraction and heart failure regardless of Hx- HTN.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8