{"id":35212,"date":"2013-03-10T16:01:36","date_gmt":"2013-03-10T20:01:36","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=35212"},"modified":"2013-03-11T01:39:01","modified_gmt":"2013-03-11T05:39:01","slug":"eplerenone-may-help-prevent-heart-failure-in-acute-stemi-patients","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2013\/03\/10\/eplerenone-may-help-prevent-heart-failure-in-acute-stemi-patients\/","title":{"rendered":"Eplerenone May Help Prevent Heart Failure in Acute STEMI Patients"},"content":{"rendered":"<p><em>For more of our ACC.13 coverage of late-breaking clinical trials, interviews with the authors of the most important research, and blogs from our fellows on the most interesting presentations at the meeting, check out our <\/em><a href=\"http:\/\/blogs.nejm.org\/cardioexchange\/voices\/acc-13-headquarters\/\"><strong><em>Coverage Headquarters<\/em><\/strong><\/a><em>.<\/em><\/p>\n<p>A new trial presented at the ACC in San Francisco suggests that the mineralocorticoid-receptor antagonist eplerenone (Pfizer, Inspra) may help prevent the development of heart failure when given acutely to STEMI patients without preexisting heart failure.<\/p>\n<p>In the REMINDER trial, 1012 STEMI patients were randomized to receive eplerenone or placebo. After 10.5 months of follow-up, the primary endpoint &#8212; the time to CV mortality, rehospitalization or extended initial hospital stay due to diagnosis of HF, sustained ventricular tachycardia or fibrillation, LVEF \u226440% after 1 month, or an\u00a0elevation of BNP\/NT-proBNP after 1 month &#8212; occurred in\u00a018.4% of the eplerenone group versus 29.6% of the placebo group (adjusted HR, 0.581; 95% CI, 0.449-0.753; <em>P<\/em>&lt;0.0001).<\/p>\n<p>BNP elevations occurred in 16% of the eplerenone group versus 25.9% of the placebo group (adjusted HR; 0.584; 95% CI, 0.441-0.773; <em>P<\/em>&lt;0.0002).\u00a0Significantly more patients in the eplerenone group had elevasted or low levels of potassium, but the overall rate of adverse events was similar in both groups.<\/p>\n<p>The authors concluded that &#8220;the early addition of eplerenone to standard therapy has a beneficial effect on heart failure related\u00a0morbidity in patients presenting with acute STEMI without HF when initiated within the first 24 hours\u00a0of symptom onset.&#8221;<\/p>\n<p>\u201cThis is the first randomized trial to test a mineralocorticoid receptor agonist during the acute phase of heart attack, and the results suggest a clinical benefit,\u201d said Gilles Montalescot, lead investigator of the study, in an ACC press release.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>For more of our ACC.13 coverage of late-breaking clinical trials, interviews with the authors of the most important research, and blogs from our fellows on the most interesting presentations at the meeting, check out our Coverage Headquarters. A new trial presented at the ACC in San Francisco suggests that the mineralocorticoid-receptor antagonist eplerenone (Pfizer, Inspra) [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,14],"tags":[545,287,245],"class_list":["post-35212","post","type-post","status-publish","format-standard","hentry","category-general","category-heart-failure","tag-eplerenone","tag-heart-failure-2","tag-mi"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/35212","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=35212"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/35212\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=35212"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=35212"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=35212"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}