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Sökning: onr:"swepub:oai:DiVA.org:liu-135708" > Aldosterone Does No...

Aldosterone Does Not Predict Cardiovascular Events Following Acute Coronary Syndrome in Patients Initially Without Heart Failure

Pitts, Reynaria (författare)
VA Medical Centre, CO USA; University of Colorado, CO USA
Gunzburger, Elise (författare)
University of Colorado, CO USA
Ballantyne, Christie M. (författare)
Baylor Coll Med, TX 77030 USA
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Barter, Philip J. (författare)
University of New South Wales, Australia
Kallend, David (författare)
Medicines Co, Switzerland
Leiter, Lawrence A. (författare)
University of Toronto, Canada; University of Toronto, Canada
Leitersdorf, Eran (författare)
Hadassah Hebrew University, Israel
Nicholls, Stephen J. (författare)
University of Adelaide, Australia; University of Adelaide, Australia
Shah, Prediman K. (författare)
Cedars Sinai Heart Institute, CA USA
Tardif, Jean-Claude (författare)
University of Montreal, Canada
Olsson, Anders, 1940- (författare)
Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Endokrinmedicinska kliniken
McMurray, John J. V. (författare)
University of Glasgow, Scotland
Kittelson, John (författare)
University of Colorado, CO USA
Schwartz, Gregory G. (författare)
VA Medical Centre, CO USA; University of Colorado, CO USA
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 (creator_code:org_t)
WILEY-BLACKWELL, 2017
2017
Engelska.
Ingår i: Journal of the American Heart Association. - : WILEY-BLACKWELL. - 2047-9980. ; 6:1
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Background- Aldosterone may have adverse effects in the myocardium and vasculature. Treatment with an aldosterone antagonist reduces cardiovascular risk in patients with acute myocardial infarction complicated by heart failure (HF) and left ventricular systolic dysfunction. However, most patients with acute coronary syndrome do not have advanced HF. Among such patients, it is unknown whether aldosterone predicts cardiovascular risk. Methods and Results- To address this question, we examined data from the dal-OUTCOMES trial that compared the cholesteryl ester transfer protein inhibitor dalcetrapib with placebo, beginning 4 to 12 weeks after an index acute coronary syndrome. Patients with New York Heart Association class II (with LVEF amp;lt; 40%), III, or IV HF were excluded. Aldosterone was measured at randomization in 4073 patients. The primary outcome was a composite of coronary heart disease death, nonfatal myocardial infarction, stroke, hospitalization for unstable angina, or resuscitated cardiac arrest. Hospitalization for HF was a secondary endpoint. Over a median follow-up of 37 months, the primary outcome occurred in 366 patients (9.0%), and hospitalization for HF occurred in 72 patients (1.8%). There was no association between aldosterone and either the time to first occurrence of a primary outcome (hazard ratio for doubling of aldosterone 0.92, 95% confidence interval 0.78-1.09, P=0.34) or hospitalization for HF (hazard ratio 1.38, 95% CI 0.96-1.99, P=0.08) in Cox regression models adjusted for covariates. Conclusions- In patients with recent acute coronary syndrome but without advanced HF, aldosterone does not predict major cardiovascular events.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

acute coronary syndrome; aldosterone; morbidity/mortality

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