The safety of mineralocorticoid receptor antagonists (MRAs) in patients with heart failure.
Identifieur interne : 000013 ( PubMed/Corpus ); précédent : 000012; suivant : 000014The safety of mineralocorticoid receptor antagonists (MRAs) in patients with heart failure.
Auteurs : Bertram Pitt ; Patrick RossignolSource :
- Expert opinion on drug safety [ 1744-764X ] ; 2016.
Abstract
Mineralocorticoid receptor antagonists (MRAs) have been accorded a class 1 indication for patients with chronic heart failure and a reduced left ventricular ejection fraction (HFREF) in both European and American guidelines. Uptake, however, has been less than optimal largely due to concerns about their safety, in particular the risk of hyperkalemia and renal dysfunction.
DOI: 10.1517/14740338.2016.1163335
PubMed: 26958701
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The safety of mineralocorticoid receptor antagonists (MRAs) in patients with heart failure.</title><author><name sortKey="Pitt, Bertram" sort="Pitt, Bertram" uniqKey="Pitt B" first="Bertram" last="Pitt">Bertram Pitt</name><affiliation><nlm:affiliation>a School of Medicine , University of Michigan , Ann Arbor , MI , USA.</nlm:affiliation></affiliation></author><author><name sortKey="Rossignol, Patrick" sort="Rossignol, Patrick" uniqKey="Rossignol P" first="Patrick" last="Rossignol">Patrick Rossignol</name><affiliation><nlm:affiliation>b Inserm, Centre d'Investigations Cliniques- Plurithématique 14-33, Inserm U1116, CHU Nancy , Université de Lorraine, Association Lorraine de Traitement de l'Insuffisance Rénale, and F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists) , Nancy , France.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:26958701</idno><idno type="pmid">26958701</idno><idno type="doi">10.1517/14740338.2016.1163335</idno><idno type="wicri:Area/PubMed/Corpus">000013</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000013</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">The safety of mineralocorticoid receptor antagonists (MRAs) in patients with heart failure.</title><author><name sortKey="Pitt, Bertram" sort="Pitt, Bertram" uniqKey="Pitt B" first="Bertram" last="Pitt">Bertram Pitt</name><affiliation><nlm:affiliation>a School of Medicine , University of Michigan , Ann Arbor , MI , USA.</nlm:affiliation></affiliation></author><author><name sortKey="Rossignol, Patrick" sort="Rossignol, Patrick" uniqKey="Rossignol P" first="Patrick" last="Rossignol">Patrick Rossignol</name><affiliation><nlm:affiliation>b Inserm, Centre d'Investigations Cliniques- Plurithématique 14-33, Inserm U1116, CHU Nancy , Université de Lorraine, Association Lorraine de Traitement de l'Insuffisance Rénale, and F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists) , Nancy , France.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Expert opinion on drug safety</title><idno type="eISSN">1744-764X</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Mineralocorticoid receptor antagonists (MRAs) have been accorded a class 1 indication for patients with chronic heart failure and a reduced left ventricular ejection fraction (HFREF) in both European and American guidelines. Uptake, however, has been less than optimal largely due to concerns about their safety, in particular the risk of hyperkalemia and renal dysfunction.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="In-Data-Review"><PMID Version="1">26958701</PMID><DateCreated><Year>2016</Year><Month>04</Month><Day>26</Day></DateCreated><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1744-764X</ISSN><JournalIssue CitedMedium="Internet"><Volume>15</Volume><Issue>5</Issue><PubDate><Year>2016</Year><Month>May</Month></PubDate></JournalIssue><Title>Expert opinion on drug safety</Title><ISOAbbreviation>Expert Opin Drug Saf</ISOAbbreviation></Journal><ArticleTitle>The safety of mineralocorticoid receptor antagonists (MRAs) in patients with heart failure.</ArticleTitle><Pagination><MedlinePgn>659-65</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1517/14740338.2016.1163335</ELocationID><Abstract><AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">Mineralocorticoid receptor antagonists (MRAs) have been accorded a class 1 indication for patients with chronic heart failure and a reduced left ventricular ejection fraction (HFREF) in both European and American guidelines. Uptake, however, has been less than optimal largely due to concerns about their safety, in particular the risk of hyperkalemia and renal dysfunction.</AbstractText><AbstractText Label="AREAS COVERED" NlmCategory="METHODS">This review presents the current state of affairs regarding the safety of MRAs in heart failure with reduced ejection fraction.</AbstractText><AbstractText Label="EXPERT OPINION" NlmCategory="CONCLUSIONS">Careful patient selection and adherence to guideline-recommended inclusion and exclusion criteria, dosing, and serial monitoring of serum potassium and renal function, along with patient education regarding the potassium content of common foods, should minimize these risks and allow increased use of MRAs. Additionally, this may also result in a further reduction in cardiovascular mortality and hospitalizations for heart failure. The development of new non-steroidal MRAs, and especially new potassium binding molecules that are well tolerated and effective, hold the promise for increased safety and, therefore, increased and more prolonged use of MRAs in patients with heart failure, especially those with chronic kidney disease, diabetes mellitus, and the elderly.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Pitt</LastName><ForeName>Bertram</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>a School of Medicine , University of Michigan , Ann Arbor , MI , USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rossignol</LastName><ForeName>Patrick</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>b Inserm, Centre d'Investigations Cliniques- Plurithématique 14-33, Inserm U1116, CHU Nancy , Université de Lorraine, Association Lorraine de Traitement de l'Insuffisance Rénale, and F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists) , Nancy , France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>04</Month><Day>11</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Expert Opin Drug Saf</MedlineTA><NlmUniqueID>101163027</NlmUniqueID><ISSNLinking>1474-0338</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Heart failure</Keyword><Keyword MajorTopicYN="N">hyperkalemia</Keyword><Keyword MajorTopicYN="N">mineralocorticoid receptor antagonist</Keyword><Keyword MajorTopicYN="N">renal function</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="aheadofprint"><Year>2016</Year><Month>4</Month><Day>11</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2016</Year><Month>3</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>3</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>3</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">26958701</ArticleId><ArticleId IdType="doi">10.1517/14740338.2016.1163335</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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