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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 without a recent CV hospitalisation were eligible for enrolment if they had a measured b-type natriuretic peptide (BNP) level ≥250 pg/ml or N-terminal-proBNP ≥500 pg/ml in men or ≥750 pg/ml in …
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