scholarly journals Mineralocorticoid Receptor Antagonists in the Treatment of Coronary Artery Disease, Myocardial Infarction and Heart Failure

2019 ◽  
Author(s):  
Carolin Zwadlo ◽  
Johann Bauersachs
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Mineralocorticoid Receptor ◽  
Mineralocorticoid Receptor Antagonists ◽  
Receptor Antagonists ◽  
Artery Disease

Abstract P380: Coronary Artery Disease Extent is Predictive of Heart Failure Incidence After Myocardial Infarction

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Yariv Gerber ◽  
Susan A Weston ◽  
Maurice E Sarano ◽  
Sheila M Manemann ◽  
Alanna M Chamberlain ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Proportional Hazards ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Disease Extent ◽  
Increased Risk ◽  
Artery Disease

Background: Little is known about the association between coronary artery disease (CAD) and the risk of heart failure (HF) after myocardial infarction (MI), and whether it differs by reduced (HFrEF) or preserved (HFpEF) ejection fraction (EF) has yet to be determined. Subjects and Methods: Olmsted County, Minnesota residents (n=1,924; mean age, 64 years; 66% male) with first MI diagnosed in 1990-2010 and no prior HF were followed through 2013. Framingham Heart Study criteria were used to define HF, which was further classified according to EF (applying a 50% cutoff). The extent of angiographic CAD was defined at index MI according to the number of major epicardial coronary arteries with ≥50% lumen diameter obstruction. Fine & Gray and Cox proportional hazards regression models were used to assess the association of CAD categories with incidence of HF, and multiple imputation methodology was applied to account for the 19% with missing EF data. Results: During a mean (SD) follow-up of 6.7 (5.9) years, 594 patients developed HF. Adjusted for age and sex, with death considered a competing risk, the cumulative incidence rates of HF among patients with 1- (n=581), 2- (n=622), and 3-vessel disease (n=721) were 11.2%, 14.6% and 20.5% at 30 days; and 18.1%, 22.3% and 29.4% at 5 years after MI, respectively. The increased risk of HF with greater number of occluded vessels was only modestly attenuated after further adjustment for patient and MI characteristics, and did not differ materially by EF (Table). Conclusions: The extent of angiographic CAD expressed by the number of diseased vessels is independently associated with HF incidence after MI. The association is evident promptly after MI and applies to both HFrEF and HFpEF.

Mineralocorticoid receptor antagonists

ESC CardioMed ◽  
2018 ◽  
pp. 167-173
Author(s):  
Faiez Zannad ◽  
João Pedro Ferreira
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Adverse Effects ◽  
Beneficial Effect ◽  
Mechanism Of Action ◽  
Mineralocorticoid Receptor ◽  
Post Myocardial Infarction ◽  
Mineralocorticoid Receptor Antagonists ◽  
Receptor Antagonists ◽  
Clinical Syndromes

Hypertension, post-myocardial infarction, and heart failure are the cardiovascular clinical syndromes where mineralocorticoid receptor antagonists (MRAs) have shown a beneficial effect. Most guidelines while recommending a MRA do not make a clear recommendation as to which MRA should be used, how doses should be titrated, or which monitorization is indicated. This chapter provides an appraisal of the different types of MRA drugs and their pharmacological differences with respect to mechanism of action, pharmacokinetics, monitoring, adverse effects, and drug interactions.

scholarly journals Aldosterone, mortality, and acute ischaemic events in coronary artery disease patients outside the setting of acute myocardial infarction or heart failure

2011 ◽  
Vol 33 (2) ◽  
pp. 191-202 ◽  
Author(s):  
Fabrice Ivanes ◽  
Sophie Susen ◽  
Frédéric Mouquet ◽  
Pascal Pigny ◽  
François Cuilleret ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Coronary Artery Disease ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Artery Disease
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