A review regarding the article 'Mineralocorticoid receptor antagonists in heart failure with reduced ejection fraction: a network meta-analysis of 32 randomized trials'.

Autor: Wang L; Department of Cardiology, West China Hospital of Sichuan University, West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, China., Yuan D; Department of Cardiovascular Surgery, Chengdu Shang Jin Nan Fu Hospital, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China. Electronic address: yuandou85422897@163.com.
Jazyk: angličtina
Zdroj: Current problems in cardiology [Curr Probl Cardiol] 2024 Aug; Vol. 49 (8), pp. 102644. Date of Electronic Publication: 2024 May 13.
DOI: 10.1016/j.cpcardiol.2024.102644
Abstrakt: Heart failure (HF) is a prevalent clinical syndrome characterized by significant morbidity and is often precipitated by impaired left ventricular myocardial function. The condition can be categorized into two primary forms based on the ejection fraction (EF): Heart failure with preserved ejection fraction (HFpEF) and Heart failure with reduced ejection fraction (HFrEF). Evidence-based treatments for HF have been instrumental in reducing morbidity and mortality, particularly in patients with HFrEF. Mineralocorticoid receptor antagonists (MRAs) represent a cornerstone in the pharmacological management of HF, with a strong indication for use in HFrEF. Notably, pharmacological nuances exist among MRAs, which may influence therapeutic decision-making for individual patients. Moreover, MRAs have been shown to enhance heart rate variability and improve cardiac sympathetic nervous system function in HF patients. Spironolactone, an MRA, has been a pivotal agent in the clinical management of HFrEF since its introduction. However, its use has been tempered by certain side effects, including gynecomastia and hyperkalemia, leading to considerable discontinuation rates among patients. To address these challenges, numerous randomized clinical trials (RCTs) have been conducted to assess the efficacy and safety profiles of alternative steroidal and non-steroidal MRAs. Eplerenone, a steroidal MRA introduced subsequent to spironolactone, has demonstrated efficacy with a more favorable side effect profile.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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