Abstract 10483: Does Eplerenone Provide Additional Clinical Benefit In Patients with Mild Symptoms of Systolic Heart Failure Already Receiving Optimal Background Drug Therapy?: Analysis of EMPHASIS-HF
Background: In EMPHASIS-HF, eplerenone (EPL) significantly reduced major CV events vs placebo (PBO) in patients with mild symptoms of systolic heart failure (HF). However, it is not known whether such benefits were preserved in patients receiving optimal background drug therapy, ie. high doses of ACE-inhibitor ([ACEi] or ARB or both) and beta-blocker (BB).
Methods: We therefore analysed EMPHASIS-HF according to use and dose of these background drug classes. Patients receiving 50% or greater of target dose were considered to be receiving “high” doses; patients on <50% or no drug comprised the “low” dose group. The study's primary endpoint (CV death/HF hospitalisation) as well as all-cause mortality was evaluated in this way.
Results: Table summarises the findings of this analysis. In general, the beneficial effects of EPL were preserved in patients receiving higher doses of ACEi, BB or both, with no significant p value for interaction between high and low doses for the primary endpoint and for all-cause mortality.
Conclusions: EPL provides substantial benefit on major events in patients with mild systolic HF, even in those already receiving high doses of standard background therapies.
- © 2011 by American Heart Association, Inc.