A new trial presented at the ACC in San Francisco suggests that the mineralocorticoid receptor antagonist eplerenone Pfizer, Inspra) may help prevent the development of heart failure when given acutely in STEMI patients without preexisting heart failure.
In the REMINDER trial 1,012 STEMI patients were randomized to eplerenone or placebo. After 10.5 months of followup, the primary endpoint– the time to CV mortality, rehospitalization or extended initial hospital stay due to diagnosis of HF, sustained ventricular tachycardia or fibrillation, EF ≤40% after 1 month, or an elevation of BNP/NT-proBNP after 1 month– occurred in 18.4% of the eplerenone group versus 29.6% of the placebo group ((HR, 0.581; 95% CI; 0.449-0.753; P<0.0001).
