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

http://dx.doi.org/10.1136/ebm.11.1.14

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    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.
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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

    Embedded ImageDesign:

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

    Embedded ImageAllocation:

    {concealed}†.*

    Embedded ImageBlinding:

    blinded (clinicians, patients, outcome assessors {data collectors, data analysts, and manuscript writers}†).*

    Embedded ImageFollow up period:

    30 days.

    Embedded ImageSetting:

    674 centres in 37 countries.

    Embedded ImagePatients:

    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.

    Embedded ImageIntervention:

    eplerenone, 25 mg/day …

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    Footnotes

    • ↵* See glossary.

    • ↵† Information provided by author.

    • For correspondence: Dr B Pitt, University of Michigan School of Medicine, Ann Arbor, MI, USA. bpitt{at}med.umich.edu

    • Source of funding: Pfizer Inc.

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