, Volume 8, Issue 2, pp 87-90
Date: 22 Mar 2011

Mineralocorticoid-receptor Antagonists in Heart Failure: A Tale of Serendipity and Success

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Zannad F, McMurray JJ, Krum H, van Veldhuisen DJ, Swedberg K, Shi H, et al. for the EMPHASIS-HF Study Group. Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms. N Engl J Med. 2011;364:11–21.

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Introduction: In the landmark Randomized Aldactone Evaluation Study (RALES), the mineralocorticoid-receptor antagonist spironolactone significantly reduced all-cause mortality when compared with placebo in elderly patients with New York Heart Association (NYHA) class III to IV systolic heart failure treated with angiotensin-converting enzyme (ACE) inhibitors [1]. More recently, the Eplerenone Post–Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS) demonstrated reduction in all-cause mortality with the mineralocorticoid-receptor antagonist eplerenone when compared with placebo in patients with severe left ventricular systolic dysfunction after myocardial infarction [2]. These studies are important contributions to the knowle