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Randomised controlled trial
Eplerenone reduces risk of cardiovascular death or hospitalisation in heart failure patients with reduced ejection fraction
  1. Andrew Ambrosy1,
  2. Mihai Gheorghiade1
  1. 1Center for Cardiovascular Innovation, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
  1. Correspondence to Mihai Gheorghiade
    Cardiovascular Center for Drug Development, Duke University, 645 North Michigan Avenue, Suite 1006, Chicago, IL 60611, USA; m-gheorghiade{at}

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Mineralocorticoid receptor antagonists (MRAs) have been shown to decrease all-cause mortality and cardiovascular (CV) hospitalisation in patients with moderate-to-severe heart failure (HF) (ie, New York Heart Association (NYHA) class III and IV symptoms) with a reduced ejection fraction (EF)1 and in patients with acute myocardial infarction complicated by HF with systolic dysfunction.2 The aim of EMPHASIS-HF was to investigate the effects of eplerenone, in addition to evidence-based background therapy, on clinical outcomes in patients with mild HF (ie, NYHA class II symptoms) with a reduced EF.


Patients ≥55 years of age with NYHA functional class II symptoms, an EF ≤30%, treated with an ACE inhibitor/angiotensin receptor blocker and a β-blocker, and a history of CV-related hospitalisation within the past 6 months were enrolled. Patients …

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