Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/107536/1/ejhf88.pd

Amano

Bacchetta

Beygui

Dickstein

Endemann

Hadoke

Hunt

Iqbal

Ishizawa

Jessup

Kayes-Wandover

Keeley

Keidar

Kursaklioglu

McMurray

O'Gara

Pitt

Suzuki

Thum

Van Belle

Wakabayashi

Ward

Wijns

Zannad

European Journal of Heart Failure

International audienceAIMS:EPHESUS was a multicentre, double-blind clinical trial in which 6632 patients with acute myocardial infarction (AMI) complicated by LV systolic dysfunction (LVSD) were randomized to receive eplerenone (n = 3319) or placebo (n = 3313). A total of 1580 EPHESUS patients were treated with PCI, which is now the standard treatment for AMI. This EPHESUS substudy examined the effects of eplerenone upon cardiovascular outcomes in PCI-treated patients.METHODS AND RESULTS:EPHESUS patients were divided into PCI-treated and non-PCI-treated cohorts, and the effect of eplerenone upon mortality and other major adverse cardiovascular outcomes was assessed in each cohort. The PCI-treated patients (n = 1580) were younger, and had better renal function and fewer co-morbidities than non-PCI-treated patients (n = 5052). Cardiovascular mortality was significantly lower in PCI-treated patients as compared with non-PCI-treated patients (7% vs. 16%, P < 0.0001). However, the incidence of non-fatal events was similar in PCI-treated and non-PCI-treated cohorts. There was no statistical difference between the PCI-treated and non-PCI-treated cohorts in the primary or secondary outcomes of the trial. Eplerenone administration, compared with placebo, in the PCI-treated cohort did not affect PCI-related clinical outcomes, including recurrence of angina, the occurrence of acute coronary syndromes, or the need for further revascularization.CONCLUSIONS:The beneficial effects of eplerenone in the EPHESUS trial exist for both PCI- and non-PCI-treated AMI patients with LVSD. Eplerenone has minimal, if any, effect upon reducing PCI-related adverse events in the PCI-treated cohort

Iqbal, Javaid

Fay, Renaud

Adlam, David

Squire, Iain

Parviz, Yasir

Gunn, Julian

Pitt, Bertram

Zannad, Faiez

HAL portal of the University of Lorraine

Effect of eplerenone in percutaneous coronary intervention-treated post-myocardial infarction patients with left ventricular systolic dysfunction: a subanalysis of the EPHESUS trial

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Effect of eplerenone in percutaneous coronary intervention‐treated post‐myocardial infarction patients with left ventricular systolic dysfunction: a subanalysis of the  EPHESUS  trial

Effect of eplerenone in percutaneous coronary intervention‐treated post‐myocardial infarction patients with left ventricular systolic dysfunction: a subanalysis of the EPHESUS trial

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