Spironolactone Use After Percutaneous Intervention for Acute Myocardial Infarction

In a randomized trial, spironolactone did not reduce risk for adverse cardiovascular events after MI.

Mineralocorticoid receptor antagonists (MRAs) reduce morbidity and mortality in patients with heart failure and in those with acute myocardial infarction (MI) who have left ventricular (LV) systolic dysfunction. To assess whether routine spironolactone use after myocardial infarction is beneficial, investigators randomized more than 7000 patients who had undergone percutaneous coronary intervention (PCI) after MI to receive spironolactone or placebo. They examined two composite primary outcomes: cardiovascular death or new or worsening heart failure; and cardiovascular death, MI, stroke, or new or worsening heart failure.

At 1 year, systolic blood pressure was lower in patients randomized to spironolactone (mean, 127 mm Hg, vs. 130 mm Hg in …

Reviewing Author

Karol E. Watson, MD, PhD, FACC

Disclosures

Consultant/Advisory BoardBoehringer Ingelheim; Amgen; Novartis; Lilly; Amarin

Speaker’s BureauBoehringer Ingelheim

Grant/Research SupportNIH

Editorial BoardsCirculation (Associate Editor)