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A medicine that blocks a hormone known to damage heart muscle can significantly reduce the risk of death and hospitalization in heart attack patients who have heart failure, according to a study released at the 52nd Annual Scientific Sessions of the American College of Cardiology.
"This represents a new advance in the treatment of heart attack and heart failure," said Dr. Bertram Pitt, a cardiologist and professor of internal medicine at the University of Michigan Medical School. "Patients receiving eplerenone had 15 percent fewer deaths compared to the placebo group and 13 percent fewer cardiovascular-related deaths and cardiovascular hospitalizations."
Patients who had experienced a heart attack within 3 to 14 days before enrolling in the trial, and with an ejection fraction (pumping ability) of less than 40 percent of normal, were eligible for the EPHESUS study. Those who did not have diabetes had to exhibit signs of heart failure, such as abnormal heart and lung sounds.
Eplerenone and another drug called spironolactone block the effects of aldosterone, a hormone known to damage heart muscle and, in conjunction with a substance called angiotensin II, cause blood vessel damage.
"This hormone is turning out to be more important than anyone thought," explained Dr. Pitt. "Treatment has gotten better over the years, but mortality is still high. This is one more step toward reducing mortality and hospitalization. And it opens up tremendous opportunities in the next decade to attack this hormone system through blockade or synthesis inhibition."
Eplerenone (brand name Inspra), approved for hypertension, is not yet on the market. Spironolactone is available from various manufacturers in generic form.
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