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Safety and efficacy...
Safety and efficacy of eplerenone in patients at high-risk for hyperkalemia and/or worsening renal function: Analyses of EMPHASIS-HF study subgroups
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Eschalier, R. (author)
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McMurray, J. J. (author)
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- Swedberg, Karl, 1944 (author)
- Gothenburg University,Göteborgs universitet,Centrum för personcentrerad vård vid Göteborgs universitet (GPCC),Institutionen för medicin, avdelningen för molekylär och klinisk medicin,University of Gothenburg Centre for person-centred care (GPCC),Institute of Medicine, Department of Molecular and Clinical Medicine
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van Veldhuisen, D. J. (author)
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Krum, H. (author)
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Pocock, S. J. (author)
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Shi, H. (author)
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Vincent, J. (author)
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Rossignol, P. (author)
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Zannad, F. (author)
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Pitt, B. (author)
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(creator_code:org_t)
- Elsevier BV, 2013
- 2013
- English.
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In: Journal of the American College of Cardiology. - : Elsevier BV. - 0735-1097 .- 1558-3597. ; 62:17, s. 1585-1593
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Abstract
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- OBJECTIVES: We investigated the safety and efficacy of eplerenone in patients at high-risk for hyperkalemia or worsening renal function (WRF) in EMPHASIS-HF, a trial which enrolled patients aged at least 55 years with heart failure and reduced ejection fraction (HF-REF), in NYHA functional class II and with an eGFR>30ml/min/1.73m2 and serum potassium <5.0 mmol/l. Patients were receiving optimal therapy and most had been hospitalized for a cardiovascular reason within 180 days of inclusion. BACKGROUND: Underuse of eplerenone in patients with HF-REF may be due to fear of inducing hyperkalemia or WRF in high-risk patients. METHODS: This was a pre-specified analysis of subgroups of patients at high-risk of hyperkalemia or WRF (patients >/=75years, with diabetes, with eGFR<60ml/min/1.73m2, and with systolic blood pressure 5.5, >6.0 and <3.5mmol/l; hyperkalemia leading to study-drug discontinuation or hospitalization; and hospitalization for WRF) as well as the primary outcome (hospitalization for HF or cardiovascular mortality). RESULTS: In all high-risk subgroups, patients treated with eplerenone had an increased risk of potassium >5.5mmol/l but not of potassium >6.0mmol/l, and of hospitalization for hyperkalemia or discontinuation of study medication due to adverse events. Eplerenone was effective in reducing the primary composite endpoint in all sub-groups. CONCLUSIONS: In patients with chronic HF-REF, in NYHA class II and meeting specific inclusion and exclusion criteria, including an eGFR >30ml/min/1.73m2 and potassium <5.0 mmol/l, eplerenone was both efficacious and safe when carefully monitored, even in subgroups at high-risk of developing hyperkalemia or WRF.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
Keyword
- chronic kidney disease; diabetes; efficacy; elderly; eplerenone; safety
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Eschalier, R.
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McMurray, J. J.
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Swedberg, Karl, ...
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van Veldhuisen, ...
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Krum, H.
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Pocock, S. J.
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show more...
-
Shi, H.
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Vincent, J.
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Rossignol, P.
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Zannad, F.
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Pitt, B.
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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Journal of the A ...
- By the university
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University of Gothenburg