Adjunctive treatment with eplerenone reduced 30-day all-cause mortality in acute myocardial infarction: COMMENTARY

Moyer, Carey D.; Berger, Peter B.
January 2006
ACP Journal Club;Jan/Feb2006, Vol. 144 Issue 1, p15
Academic Journal
This article comments on the clinical trial EPHESUS, according to which adjunctive treatment with eplerenone reduced 30-day all-cause mortality in acute myocardial infarction (MI). Based largely on this trial, the U.S. Food and Drug Administration approved eplerenone in October 2003 for use in patients with congestive heart failure after acute MI. However, if the benefits of eplerenone are to be realized in clinical practice, hyperkalemia ought to be looked for as diligently as it was in the trial. Given the large clinical benefit derived within even 30 days, the question arises whether eplerenone might be beneficial if started even earlier than 3 to 14 days after MI. A cost-effectiveness analysis from EPHESUS showed that the increased survival of patients treated with eplerenone cost $1391 during the 16-month follow-up.


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