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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 ★★★★★★☆ Internal medicine ★★★★★★☆ Cardiology ★★★★★☆☆
METHODS
Design:
randomised placebo controlled trial (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study [EPHESUS]).
Allocation:
{concealed}†.*
Blinding:
blinded (clinicians, patients, outcome assessors {data collectors, data analysts, and manuscript writers}†).*
Follow up period:
30 days.
Setting:
674 centres in 37 countries.
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.
Intervention:
eplerenone, 25 mg/day …
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