Moderate renal insufficiency does not attenuate the clinical benefit of aldosterone antagonists in heart failure

Journal of the American College of Cardiology

Volumn 60, Issue 20, 2012, Pages 2090-2091

  Kiernan, Michael S ^a   Konstam, Marvin A ^a  

^a TUFTS UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

heart failure; renal dysfunction; spironolactone

Indexed keywords

ALDOSTERONE ANTAGONIST; ENALAPRIL; EPLERENONE; PLACEBO; SPIRONOLACTONE;

CHRONIC KIDNEY DISEASE; CLINICAL TRIAL (TOPIC); HEART FAILURE; HEART LEFT VENTRICLE EJECTION FRACTION; HEART LEFT VENTRICLE FAILURE; HUMAN; HYPERKALEMIA; KIDNEY DYSFUNCTION; KIDNEY FAILURE; MORTALITY; NOTE; PRIORITY JOURNAL; PROGNOSIS; RANDOMIZED CONTROLLED TRIAL (TOPIC); RISK BENEFIT ANALYSIS; RISK FACTOR; TREATMENT OUTCOME; WORSENING RENAL FUNCTION;

EID: 84868543764     PISSN: 07351097     EISSN: 15583597     Source Type: Journal    
DOI: 10.1016/j.jacc.2012.08.971     Document Type: Editorial

References (15)

1. B. Pitt, F. Zannad, W.J. Remme Randomized Aldactone Evaluation Study Investigators The effect of spironolactone on morbidity and mortality in patients with severe heart failure N Engl J Med 341 1999 709 717
2. F. Zannad, J.J. McMurray, H. Krum Eplerenone in patients with systolic heart failure and mild symptoms N Engl J Med 364 2011 11 21
3. U.D. Patel, A.F. Hernandez, L. Liang Quality of care and outcomes among patients with heart failure and chronic kidney disease: a Get With the Guidelines - Heart Failure Program study Am Heart J 156 2008 674 681
4. A. Al-Ahmad, W.M. Rand, G. Manjunath Reduced kidney function and anemia as risk factors for mortality in patients with left ventricular dysfunction J Am Coll Cardiol 38 2001 955 962
5. J. Ezekowitz, F.A. McAlister, K.H. Humphries The association among renal insufficiency, pharmacotherapy, and outcomes in 6,427 patients with heart failure and coronary artery disease J Am Coll Cardiol 44 2004 1587 1592
6. O. Vardeny, D. Hong Wu, A. Desai Influence of baseline and worsening renal function on efficacy of spironolactone in patients with severe heart failure: insights from RALES (Randomized Aldactone Evaluation Study) J Am Coll Cardiol 60 2012 2082 2089
7. S.D. Navaneethan, S.U. Nigwekar, A.R. Sehgal, G.F. Strippoli Aldosterone antagonists for preventing the progression of chronic kidney disease: a systematic review and meta-analysis Clin J Am Soc Nephrol 4 2009 542 551
8. N.J. Brown Aldosterone and vascular inflammation Hypertension 51 2008 161 167
9. D.G. Kramer, T.A. Trikalinos, D.M. Kent, G.V. Antonopoulos, M.A. Konstam, J.E. Udelson Quantitative evaluation of drug or device effects on ventricular remodeling as predictors of therapeutic effects on mortality in patients with heart failure and reduced ejection fraction: a meta-analytic approach J Am Coll Cardiol 56 2010 392 406
10. J.E. Udelson, A.M. Feldman, B. Greenberg Randomized, double-blind, multicenter, placebo-controlled study evaluating the effect of aldosterone antagonism with eplerenone on ventricular remodeling in patients with mild-to-moderate heart failure and left ventricular systolic dysfunction Circ Heart Fail 3 2010 347 353
11. N.C. Edwards, R.P. Steeds, P.M. Stewart, C.J. Ferro, J.N. Townend Effect of spironolactone on left ventricular mass and aortic stiffness in early-stage chronic kidney disease: a randomized controlled trial J Am Coll Cardiol 54 2009 505 512
12. A. McCurley, I.Z. Jaffe Mineralocorticoid receptors in vascular function and disease Mol Cell Endocrinol 350 2012 256 265
13. J.M. Testani, S.E. Kimmel, D.L. Dries, S.G. Coca Prognostic importance of early worsening renal function after initiation of angiotensin-converting enzyme inhibitor therapy in patients with cardiac dysfunction Circ Heart Fail 4 2011 685 691
14. P. Rossignol, J.G. Cleland, S. Bhandari Determinants and consequences of renal function variations with aldosterone blocker therapy in heart failure patients after myocardial infarction: insights from the eplerenone post-acute myocardial infarction heart failure efficacy and survival study Circulation 125 2012 271 279
15. M. Kiernan, D. Wentworth, G. Francis Predicting adverse events during angiotensin receptor blocker treatment in heart failure: results from the HEAAL trial Eur J Heart Fail 2012 In press