Eplerenone Post-Ami Heart Failure Efficacy And Survival Study
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Acronym
EPHESUS stands for Eplerenone Post-AMI Heart Failure Efficacy and Survival Trial.
Background
Eplerenone is an aldosterone antagonist that blocks the mineralocorticoid receptor, but not the glucocorticoid, progesterone, or androgen receptors and for that reason it may may be associated with fewer side effects than spironolactone.
Results
EPHESUS: Primary and secondary end points
|
End point
|
Eplerenone, No. (%)
|
Placebo, No. (%)
|
Relative risk (95% CI)
|
p
|
| Mortality* | 478 (14.4) | 554 (16.7) | 0.85 (0.75-0.96) |
0.008 |
| Cardiovascular mortality | 407 (12.3) | 483 (14.6) | 0.83 (0.72-0.94) |
0.005 |
| CV mortality or hospitalization for CV events* | 885 (26.7) | 993 (30.0) | 0.87 (0.79-0.95) |
0.002 |
*Primary end points
Number Needed to Treat (NNT) = 50 patients to save one life, and 33 to prevent one cardiovascular death or rehospitalization.
Summary
Among MI patients with LV dysfunction, the administration of eplerenone (Inspra®, Pharmacia) in addition to evidence based therapy is associated with a 15% reduction in all cause mortality. In addition, cardiovascular death, and CV death and hospitalization were also significantly reduced.