Abstract
The pathophysiology of heart failure (HF) is related to the overactivation of the mineralocorticoid receptor, leading to fluid retention and adverse myocardial remodeling. Although mineralocorticoid receptor antagonists (MRAs) are recommended for the treatment of heart failure with reduced ejection fraction (HFrEF), they remain underused due to adverse effects such as hyperkalemia; and their efficacy is controversial in heart failure with mildly reduced ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF). Recent trials in people with diabetes and kidney disease have supported the use of nonsteroidal MRAs in reducing HF-related morbidity and mortality and have fewer side effects than their steroidal counterparts. The efficacy and safety of nonsteroidal MRAs have not been tested in HF and are currently being evaluated in additional clinical trials. This review comprehensively examines the current data regarding MRAs for HF and the future direction of nonsteroidal MRA research while exploring the causes of MRA underutilization.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1979-1993 |
| Number of pages | 15 |
| Journal | JACC: Heart Failure |
| Volume | 12 |
| Issue number | 12 |
| DOIs | |
| State | Published - Dec 2024 |
Bibliographical note
Publisher Copyright:© 2024 American College of Cardiology Foundation
Keywords
- heart failure
- mineralocorticoid receptor antagonist
PubMed: MeSH publication types
- Journal Article
- Review
