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Evidence-Based Medicine 2006;11:14; doi:10.1136/ebm.11.1.14
Copyright © 2006 by the BMJ Publishing Group Ltd.
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Therapeutics

Adjunctive treatment with eplerenone reduced 30 day all cause mortality in acute myocardial infarction

Pitt B, White H, Nicolau J, et al. Eplerenone reduces mortality 30 days after randomization following acute myocardial infarction in patients with left ventricular systolic dysfunction and heart failure. J Am Coll Cardiol 2005;46:425–31.[Abstract/Free Full Text]

Q In patients with acute myocardial infarction (MI) complicated by left ventricular systolic dysfunction (LVSD) and heart failure, does adjunctive treatment with eplerenone reduce morbidity and mortality more than placebo?

Clinical impact ratings IM/Ambulatory care ******{star} Internal medicine ******{star} Cardiology *****{star}{star}

Key Words: eplerenone • heart failure • congestive • myocardial infarction • ventricular dysfunction (left)

The first 150 words of the full text of this article appear below.

METHODS
Formula Design: randomised placebo controlled trial (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study [EPHESUS]).

Formula Allocation: {concealed}{dagger}.*

Formula Blinding: blinded (clinicians, patients, outcome assessors {data collectors, data analysts, and manuscript writers}{dagger}).*

Formula Follow up period: 30 days.

Formula Setting: 674 centres in 37 countries.

Formula Patients: 6632 patients (mean age 64 y, 70% men) with acute MI complicated by LVSD (ejection fraction <=40%) and heart failure. Exclusion criteria included serum creatinine >=220 µmol/l (2.5 mg/dl) and serum potassium >5.0 mmol/l.

Formula Intervention: eplerenone, 25 mg/day (n = 3319) or placebo (n = 3313) started at 3–14 days after acute MI. All patients received usual medical care.

Formula Outcomes: time to death from any cause and time to the composite outcome of death from cardiovascular (CV) causes or first hospital admission for a CV event (heart failure, recurrent acute MI, stroke, or ventricular arrhythmia).

Formula Patient follow-up: 100% (intention to treat analysis).

MAIN RESULTS
The rate of . . . [Full text of this article]

Carey D Moyer, MD, Peter B Berger, MD

Duke Clinical Research Institute
Durham, North Carolina, USA


Related Article

Glossary
Evid. Based Med. 2006 11: 31. (in Glossary) [Extract] [Full Text] [PDF]





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