History of Hypertension and the Effects of Eplerenone in Patients with Acute Myocardial Infarction Complicated by Systolic Heart Failure
Identifieur interne : 001E36 ( Pmc/Curation ); précédent : 001E35; suivant : 001E37History of Hypertension and the Effects of Eplerenone in Patients with Acute Myocardial Infarction Complicated by Systolic Heart Failure
Auteurs : Bertram Pitt ; Ali Ahmed ; Thomas E. Love ; Henry Krum ; Jose Nicolau ; José Silva Cardoso ; Alexander Parkhomenko ; Michael Aschermann ; Ramon Corbalán ; Henry Solomon ; Harry Shi ; Faiez ZannadSource :
- Hypertension [ 0194-911X ] ; 2008.
Abstract
In the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (n=6632), eplerenone-associated reduction in all-cause mortality was significantly greater in those with a history of hypertension (Hx-HTN). There were 4007 patients with Hx-HTN (eplerenone: n=1983) and 2625 patients without Hx-HTN (eplerenone: n=1336). Propensity scores for eplerenone use, separately calculated for patients with and without Hx-HTN, were used to assemble matched cohorts of 1838 and 1176 pairs of patients. In patients with Hx-HTN, all-cause mortality occurred in 18% of patients treated with placebo (rate, 1430/10 000 person-years) and 14% of patients treated with eplerenone (rate, 1058/10 000 person-years) during 2350 and 2457 years of follow-up, respectively (hazard ratio [HR]: 0.71; 95% CI: 0.59 to 0.85; P<0.0001). Composite end point of cardiovascular hospitalization or cardiovascular mortality occurred in 33% of placebo-treated patients (3029/10 000 person-years) and 28% of eplerenone-treated patients (2438/10 000 person-years) with Hx-HTN (HR: 0.82; 95% CI: 0.72 to 0.94; P=0.003). In patients without Hx-HTN, eplerenone reduced heart failure hospitalization (HR: 0.73; 95% CI: 0.55 to 0.97; P=0.028) but had no effect on mortality (HR: 0.91; 95% CI: 0.72 to 1.15; P=0.435) or on the composite end point (HR: 0.91; 95% CI: 0.76 to 1.10; P=0.331). Eplerenone should, therefore, be prescribed to all of the post–acute myocardial infarction patients with reduced left ventricular ejection fraction and heart failure regardless of Hx-HTN.
Url:
DOI: 10.1161/HYPERTENSIONAHA.107.109314
PubMed: 18559720
PubMed Central: 3782417
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<series><title level="j">Hypertension</title>
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<front><div type="abstract" xml:lang="en"><p id="P1">In the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (n=6632), eplerenone-associated reduction in all-cause mortality was significantly greater in those with a history of hypertension (Hx-HTN). There were 4007 patients with Hx-HTN (eplerenone: n=1983) and 2625 patients without Hx-HTN (eplerenone: n=1336). Propensity scores for eplerenone use, separately calculated for patients with and without Hx-HTN, were used to assemble matched cohorts of 1838 and 1176 pairs of patients. In patients with Hx-HTN, all-cause mortality occurred in 18% of patients treated with placebo (rate, 1430/10 000 person-years) and 14% of patients treated with eplerenone (rate, 1058/10 000 person-years) during 2350 and 2457 years of follow-up, respectively (hazard ratio [HR]: 0.71; 95% CI: 0.59 to 0.85; P<0.0001). Composite end point of cardiovascular hospitalization or cardiovascular mortality occurred in 33% of placebo-treated patients (3029/10 000 person-years) and 28% of eplerenone-treated patients (2438/10 000 person-years) with Hx-HTN (HR: 0.82; 95% CI: 0.72 to 0.94; P=0.003). In patients without Hx-HTN, eplerenone reduced heart failure hospitalization (HR: 0.73; 95% CI: 0.55 to 0.97; P=0.028) but had no effect on mortality (HR: 0.91; 95% CI: 0.72 to 1.15; P=0.435) or on the composite end point (HR: 0.91; 95% CI: 0.76 to 1.10; P=0.331). Eplerenone should, therefore, be prescribed to all of the post–acute myocardial infarction patients with reduced left ventricular ejection fraction and heart failure regardless of Hx-HTN.</p>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
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<front><journal-meta><journal-id journal-id-type="nlm-journal-id">7906255</journal-id>
<journal-id journal-id-type="pubmed-jr-id">4217</journal-id>
<journal-id journal-id-type="nlm-ta">Hypertension</journal-id>
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<article-id pub-id-type="manuscript">NIHMS215965</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
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<title-group><article-title>History of Hypertension and the Effects of Eplerenone in Patients with Acute Myocardial Infarction Complicated by Systolic Heart Failure</article-title>
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<contrib-group><contrib contrib-type="author"><name><surname>Pitt</surname>
<given-names>Bertram</given-names>
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<contrib contrib-type="author"><name><surname>Ahmed</surname>
<given-names>Ali</given-names>
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<contrib contrib-type="author"><name><surname>Love</surname>
<given-names>Thomas E.</given-names>
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<contrib contrib-type="author"><name><surname>Krum</surname>
<given-names>Henry</given-names>
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<contrib contrib-type="author"><name><surname>Nicolau</surname>
<given-names>Jose</given-names>
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<contrib contrib-type="author"><name><surname>Silva Cardoso</surname>
<given-names>José</given-names>
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<contrib contrib-type="author"><name><surname>Parkhomenko</surname>
<given-names>Alexander</given-names>
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<contrib contrib-type="author"><name><surname>Aschermann</surname>
<given-names>Michael</given-names>
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<contrib contrib-type="author"><name><surname>Corbalán</surname>
<given-names>Ramon</given-names>
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<contrib contrib-type="author"><name><surname>Solomon</surname>
<given-names>Henry</given-names>
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<contrib contrib-type="author"><name><surname>Shi</surname>
<given-names>Harry</given-names>
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<contrib contrib-type="author"><name><surname>Zannad</surname>
<given-names>Faiez</given-names>
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<aff id="A1">University of Michigan Health System (B.P.), Ann Arbor, MI, USA; School of Medicine (A.A.), University of Alabama at Birmingham, and VA Medical Center, Birmingham, AL, USA; School of Medicine, Case Western Reserve University, Cleveland, OH, USA (T.E.L.); Department of Epidemiology and Preventive Medicine (H.K.), Monash University, Prahan, Australia; Heart Institute (InCOR) (J.N.), University of São Paulo Medical School, São Paulo, Brazil; Departamento de Engenharia Electrotécnica e de Computadores (J.S.C.), Faculdade de Engenharia, Universidade do Porto, Portugal; Emergency Cardiology Department (A.P.), National Institute of Cardiology, Kiev, Ukraine; Interni Klinika (M.A.), Cardiovascular Center, Prague, Czech Republic; Departamento de Enfermedades Cardiovasculares, Hospital Clínico y Facultad de Medicina (R.C.), Pontifica Universidad Catolica de Chile, Santiago, Chile; Pfizer Inc (H.S., H.S.), New York, NY, USA; Clinical Investigation Center (FZ), INSERM-CHU de Nancy Hopital Jeanne d'Arc, Dommartinles Toul, France</aff>
</contrib-group>
<author-notes><corresp id="cor1">Bertram Pitt, MD, University of Michigan, 1500 E Medical Center Drive, 3910 Taubman Center, Ann Arbor, MI 48109-0366, 734-936-5260 (phone), 734-936-5256 (fax), <email>bpitt@med.umich.edu</email>
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<pub-date pub-type="nihms-submitted"><day>16</day>
<month>5</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="epub"><day>16</day>
<month>6</month>
<year>2008</year>
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<pub-date pub-type="ppub"><month>8</month>
<year>2008</year>
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<pub-date pub-type="pmc-release"><day>24</day>
<month>9</month>
<year>2013</year>
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<volume>52</volume>
<issue>2</issue>
<fpage>271</fpage>
<lpage>278</lpage>
<abstract><p id="P1">In the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (n=6632), eplerenone-associated reduction in all-cause mortality was significantly greater in those with a history of hypertension (Hx-HTN). There were 4007 patients with Hx-HTN (eplerenone: n=1983) and 2625 patients without Hx-HTN (eplerenone: n=1336). Propensity scores for eplerenone use, separately calculated for patients with and without Hx-HTN, were used to assemble matched cohorts of 1838 and 1176 pairs of patients. In patients with Hx-HTN, all-cause mortality occurred in 18% of patients treated with placebo (rate, 1430/10 000 person-years) and 14% of patients treated with eplerenone (rate, 1058/10 000 person-years) during 2350 and 2457 years of follow-up, respectively (hazard ratio [HR]: 0.71; 95% CI: 0.59 to 0.85; P<0.0001). Composite end point of cardiovascular hospitalization or cardiovascular mortality occurred in 33% of placebo-treated patients (3029/10 000 person-years) and 28% of eplerenone-treated patients (2438/10 000 person-years) with Hx-HTN (HR: 0.82; 95% CI: 0.72 to 0.94; P=0.003). In patients without Hx-HTN, eplerenone reduced heart failure hospitalization (HR: 0.73; 95% CI: 0.55 to 0.97; P=0.028) but had no effect on mortality (HR: 0.91; 95% CI: 0.72 to 1.15; P=0.435) or on the composite end point (HR: 0.91; 95% CI: 0.76 to 1.10; P=0.331). Eplerenone should, therefore, be prescribed to all of the post–acute myocardial infarction patients with reduced left ventricular ejection fraction and heart failure regardless of Hx-HTN.</p>
</abstract>
<kwd-group><kwd>Eplerenone</kwd>
<kwd>hypertension</kwd>
<kwd>myocardial infarction</kwd>
<kwd>heart failure</kwd>
<kwd>morbidity</kwd>
<kwd>mortality</kwd>
</kwd-group>
<funding-group><award-group><funding-source country="United States">National Heart, Lung, and Blood Institute : NHLBI</funding-source>
<award-id>R01 HL085561-02 || HL</award-id>
</award-group>
</funding-group>
</article-meta>
</front>
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