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Eplerenone Reduces Mortality 30 Days After Randomization Following Acute Myocardial Infarction in Patients With Left Ventricular Systolic Dysfunction and Heart Failure

Bertram Pitt, MD, FACC^_*,_*, Harvey White, DSc, FACC, Jose Nicolau, MD, FACC, Felipe Martinez, MD, Mihai Gheorghiade, MD, FACC^||, Michael Aschermann, MD^¶, Dirk J. van Veldhuisen, MD, FACC^#, Faiez Zannad, MD^_**, Henry Krum, MD, Robin Mukherjee, PhD, John Vincent, MD, PhD for the EPHESUS Investigators

^_* University of Michigan School of Medicine, Ann Arbor, Michigan
Green Lane Cardiovascular Research Unit, Auckland City Hospital, Auckland, New Zealand
Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
Fundacion Rusculleda, Cárdoba, Argentina
^|| Northwestern University Medical School Feinberg School of Medicine, Chicago, Illinois
^¶ Interni Klinika, Cardiovascular Center, Prague, Czech Republic
^# University Hospital Groningen, Department of Cardiology, Groningen, the Netherlands
^_** Clinical Investigation Center INSERM-CHU de Nancy Hôpital Jeanne d’Arc, Dommartin-les Toul, Centre d’Investigation Clinique de Nancy, France
Monash University, Alfred Hospital, Melbourne, Australia
Pfizer Inc., New York, New York.

View larger version (20K): [in a new window]   Figure 1 Kaplan-Meier estimates of the rate of all-cause mortality (A), the rate of death from cardiovascular causes or hospitalization for cardiovascular events (B), the rate of death from cardiac causes (C), and the rate of sudden cardiac death (D). CI = confidence interval; RR = relative risk.

View larger version (24K): [in a new window]   Figure 2 Relative risk of death from any cause according to baseline demographic and clinical characteristics. The data represented are hazard ratios with 95% confidence intervals. Values for age, pulse pressure, serum potassium concentration, serum creatinine concentration, left ventricular ejection fraction (LVEF), and body mass index were dichotomized at the median value. Analyses according to the use of an angiotensin-converting enzyme inhibitor (ACEI) (or angiotensin receptor blocker [ARB]), a beta-blocker (BB), or both; according to the use of an ACEI (or ARB) with a BB, aspirin (ASA), statins, and reperfusion therapy up to 14 days after the index acute myocardial infarction (AMI); according to the use of diuretics; and according to the use of lipid-lowering agents were post-hoc analyses. PTCA = percutaneous transluminal coronary angioplasty.