TY - JOUR
T1 - Drug Insight
T2 - Aldosterone-receptor antagonists in heart failure - The journey continues
AU - Kalidindi, Srinivasa R.
AU - Tang, Wilson H.
AU - Francis, Gary S.
PY - 2007/7/1
Y1 - 2007/7/1
N2 - Aldosterone is an important mediator in the pathogenesis of heart failure, and increased plasma aldosterone levels are associated with a poor prognosis. Aldosterone-receptor blocking drugs can slow the progression of left ventricular remodeling and reduce the occurrence of sudden cardiac death. Two widely publicized clinical trials provide data demonstrating survival benefits with spironolactone and eplerenone in chronic and postinfarction heart failure. The publication of these trials has generated widespread enthusiasm for spironolactone and eplerenone, leading to the more frequent and sometimes unbridled use of these drugs in the medical community. We herein describe the likely mechanisms of action of aldosterone-receptor antagonists, discuss the existing clinical evidence supporting their use, and provide practical advice on their use in the management of patients with heart failure.
AB - Aldosterone is an important mediator in the pathogenesis of heart failure, and increased plasma aldosterone levels are associated with a poor prognosis. Aldosterone-receptor blocking drugs can slow the progression of left ventricular remodeling and reduce the occurrence of sudden cardiac death. Two widely publicized clinical trials provide data demonstrating survival benefits with spironolactone and eplerenone in chronic and postinfarction heart failure. The publication of these trials has generated widespread enthusiasm for spironolactone and eplerenone, leading to the more frequent and sometimes unbridled use of these drugs in the medical community. We herein describe the likely mechanisms of action of aldosterone-receptor antagonists, discuss the existing clinical evidence supporting their use, and provide practical advice on their use in the management of patients with heart failure.
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U2 - 10.1038/ncpcardio0914
DO - 10.1038/ncpcardio0914
M3 - Review article
C2 - 17589427
AN - SCOPUS:34250818053
SN - 1759-5002
VL - 4
SP - 368
EP - 378
JO - Nature Reviews Cardiology
JF - Nature Reviews Cardiology
IS - 7
ER -