Document Detail


Rationale for an early aldosterone blockade in acute myocardial infarction and design of the ALBATROSS trial.
MedLine Citation:
PMID:  20934557     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Aldosterone is at its highest levels at presentation for acute myocardial infarction (AMI). High aldosterone levels are predictive of poor outcome regardless of heart failure. Angiotensin-converting enzyme inhibitors have delayed partial and temporary effects on aldosterone levels. We hypothesize that aldosterone receptor blockade, early after AMI onset on top of standard therapy, may improve clinical outcome. STUDY DESIGN: ALBATROSS is a nationwide, multicenter, open-labeled, randomized trial designed to assess the superiority of aldosterone blockade by a 200-mg intravenous bolus of potassium canrenoate followed by a daily 25-mg dose of spirinolactone for 6 months, on top of standard therapy compared to standard therapy alone among 1,600 patients admitted for ST-segment elevation or high risk non-ST-segment elevation acute AMI -TIMI score ≥3-within 72 hours after symptom onset regardless of heart failure and treatment strategy. The primary efficacy end point of the study is the 6-month rate of the composite of death, resuscitated cardiac arrest, significant ventricular arrhythmia, class IA American College of Cardiology/American Heart Association/European Society of Cardiology indication for implantable cardioverter device, and new or worsening heart failure. Secondary end points include each of the components of the primary end point, different combinations of such components, the primary end point assessed at hospital discharge and 30-day follow-up, and rates of acute renal failure. Safety end points include rates of hyperkalemia and premature drug discontinuation. CONCLUSIONS: ALBATROSS will assess the cardiovascular benefit of a low-cost aldosterone receptor blocker on top of standard therapy in all-coming AMI patients.
Authors:
Farzin Beygui; Eric Vicaut; Patrick Ecollan; Jacques Machecourt; Eric Van Belle; Faiez Zannad; Gilles Montalescot
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  160     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-11     Completed Date:  2010-10-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  642-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 Mosby, Inc. All rights reserved.
Affiliation:
Institut de Cardiologie and INSERM U937, Centre Hospitalier Universitaire Pitié-Salpêtrière, Paris, France.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT01059136
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MeSH Terms
Descriptor/Qualifier:
Aged
Aldosterone / blood*
Aldosterone Antagonists / administration & dosage*
Canrenoate Potassium / administration & dosage*
Dose-Response Relationship, Drug
Electrocardiography / drug effects
Female
Follow-Up Studies
Humans
Infusions, Intravenous
Male
Myocardial Infarction / blood,  drug therapy*,  physiopathology
Treatment Outcome
Chemical
Reg. No./Substance:
0/Aldosterone Antagonists; 2181-04-6/Canrenoate Potassium; 52-39-1/Aldosterone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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