Document Detail


Aldosterone receptor antagonism and heart failure: insights from an outpatient clinic.
MedLine Citation:
PMID:  18613852     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: In randomized clinical trials, aldosterone antagonists have been shown to reduce mortality and morbidity in heart failure (HF). The aim of the present study was to examine the risk-benefit profile of aldosterone antagonists in routine clinical practice. METHODS: A retrospective analysis, extending over a 1-year period, of the clinical, instrumental and laboratory data of 264 HF outpatients was performed. All patients were on a beta-blocker and an ACE-inhibitor (or angiotensin-II receptor-blocker) and 151 were taking an aldosterone antagonist. RESULTS: At baseline, subjects treated with aldosterone antagonists had a higher NYHA class, a larger left-ventricular end-diastolic volume, a worse ejection fraction and a higher systolic pulmonary arterial pressure (sPAP). During follow-up, a greater reduction in sPAP and a tendency towards improved systolic and diastolic function were observed in subjects treated with aldosterone antagonists. Moreover, clinical and laboratory parameters did not deteriorate in patients taking aldosterone antagonists. Mortality rates were similar in the two groups (8.6% vs. 8.8%, P = NS). CONCLUSIONS: The use of aldosterone antagonists in HF is associated with an improvement in cardiac function and is well tolerated. In the present study, patients administered these agents had a comparable clinical outcome to that of the control group, despite important differences in baseline risk.
Authors:
R Mariotti; G Borelli; M Coceani; S Zingaro; A Barison; I Morelli; L Rondinini
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical pharmacy and therapeutics     Volume:  33     ISSN:  1365-2710     ISO Abbreviation:  J Clin Pharm Ther     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-10     Completed Date:  2008-08-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8704308     Medline TA:  J Clin Pharm Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  349-56     Citation Subset:  IM    
Affiliation:
Heart Failure Unit, Department of Cardiothoracic, University of Pisa, Pisa, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Aged
Aldosterone Antagonists / adverse effects,  therapeutic use*
Ambulatory Care
Angiotensin II Type 1 Receptor Blockers / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Blood Pressure / drug effects
Drug Therapy, Combination
Female
Follow-Up Studies
Heart Failure / drug therapy*,  mortality
Humans
Male
Middle Aged
Randomized Controlled Trials as Topic
Retrospective Studies
Ventricular Function, Left / drug effects
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Aldosterone Antagonists; 0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors

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