Early Post-MI Mortality Benefit of Eplerenone in Selected Patients with LVSD

Mortality rates remain high after acute MI (AMI) complicated by heart failure (HF). In the manufacturer-funded, randomized EPHESUS trial, the selective aldosterone blocker eplerenone (25 mg/day, initiated 3-14 days after AMI) was significantly better than placebo for preventing major adverse outcomes during a mean 16 months of follow-up in patients with LV systolic dysfunction (LVSD) and clinical HF or diabetes (Journal Watch Cardiology May 2 2003). Now, researchers have focused on early (30-day) mortality among the 6632 EPHESUS subjects, none of whom had baseline serum potassium concentrations >5.0 mmol/L or creatinine concentrations >2.5 mg/dL. At baseline, ACE inhibitors were being used by about 87% of subjects and beta-blockers by 75%.

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