2011 Top Game Changers in Cardiology

Henry R. Black, MD; David J. Maron, MD; Ileana L. Pina, MD; Carol Peckham

Disclosures

November 23, 2011

In This Article

And the Top Game Changer Is...

1. The results of the EMPHASIS-HF trial, published in January 2011,[8]showed that aldosterone antagonist eplerenone (Inspra®, Pfizer) produced large reductions in both the risk for death and the risk for hospitalization compared with placebo in patients with systolic heart failure and mild symptoms. Aldosterone blockade, with either spironolactone or eplerenone, had already shown benefits in class 3-4 heart failure and in post-MI patients with heart failure. These results extended the benefit to patients with mild heart failure, a much broader population. As reported in Heartwire, Dr. Mariel Jessup (University of Pennsylvania School of Medicine, Philadelphia) said: "We have very good data now that aldosterone antagonists work for patients with heart failure and are saving lives, but we need to better understand the hyperkalemia and how exactly these drugs are working. This is an exciting day indeed, as we have a large new patient population for this drug, but we still have a lot of work ahead of us."

Read the full news story on this trial here.

The EPHESUS trial,[9]published in October 2011, found that at least 3 separate therapeutic properties of the aldosterone antagonist contributed to the drug's significant clinical benefits vs placebo. The authors stated that the clinical gains with eplerenone "cannot be explained solely by the drug's diuretic and potassium-sparing properties." They concluded that the analysis provides strong evidence for beneficial pleiotropic effects of the drug in patients with heart failure, at least in the post-MI setting.

Read the full news story on this trial here.

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