Eplerenone improves clinical stability in patients hospitalized with acute heart failure: Study

The EARLIER trial comprised Japanese patients hospitalized for acute heart failure. They were randomly assigned to eplerenone or placebo for over six months. Mixed-effects models and Cox proportional hazards were used for analyses.

The authors reported the following findings:

· The study included three hundred patients (mean age, 67 ± 13 years; 73% were males). At randomization, the median furosemide equivalent dose was 40 mg.

· Patients with higher furosemide-equivalent doses had more severe signs and symptoms of congestion and a higher risk of all-cause mortality or HF hospitalization during 6-month follow-up (adjusted-hazard ratio per 10 mg/day increase = 1.25).

· Eplerenone significantly decreased furosemide-equivalent diuretic doses and b-type natriuretic levels throughout the follow-up and reduced E/e' and inferior vena cava diameter at four weeks.

· Additionally, eplerenone significantly reduced left ventricular (LV) end-diastolic diameter at 24 weeks.

"Eplerenone treatment improved clinical stability, especially during a short period after hospitalization for acute heart failure, translated by lower natriuretic peptide levels, diuretic doses, smaller LV volume, and indirect markers of filling pressure and venous congestion," Masatake Kobayashi, from Tokyo medical university in Tokyo, Japan, and colleagues wrote.

Reference:

The study, "Effect of eplerenone on clinical stability of Japanese patients with acute heart failure," was published in the International Journal of Cardiology.

DOI: https://doi.org/10.1016/j.ijcard.2022.12.045