Place of eplerenone in the therapy of cardiovascular diseases


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Abstract

The article reflects the current understanding of the place of aldosterone antagonists in the treatment of acute myocardial infarction, chronic heart failure, and arterial hypertension. The theoretical and the evidence base for the use of eplerenone in the treatment of cardiovascular disease and the necessity of its more widespread use are discussed.

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About the authors

Svetlana Nikolaevna Tolpygina

State scientific research center for preventive medicine

Email: stolpygina@gnicpm.ru
PhD, leading researcher of the Department of preventive pharmacotherapy

References

  1. Бойцов С.А., Лукьянов М.М., Якушин ЦС., Марцевич С.Ю., Воробьев А.Н., Загребельный А.В., Переверзева К.Г., Правкина Е.А., Деев А.Д., Андреенко Е.Ю., Ершова А.И., Мешков А.Н., Мясников Р.П., Сердюк С.С., Харлап М.С., Базаева Е.В., Козминский А.Н., Мосейчук К.А., Кляшторный В.Г., Кудряшов Е.В. Амбулаторно-поликлинический регистр РЕКВАЗА: данные проспективного наблюдения, оценка риска и исходы у больных кардиоваскулярными заболеваниями. Кардиоваскулярная терапия и профилактика. 2015;14(1):53-62. [Boitsov S.A., Lukiyanov M.M., Yakushin S.S., Martsevich S.Yu., Vorob'ev A.N., Zagrebelny A.V., Pereverzeva K.G., Pravkina Ye.A., Deev A.D., Andreenko E.Yu., Yershova A.I., Meshkov A.N., Myasnikov R.P., Serdyuk S.S., Kharlap S.M., Bazaeva Ye.V., Kozminsky A.N., Moseichuk K.A., Klyashtorny V.G., Kudryashov Ye.V. Outpatient register Rekvaza: data from the prospective study, risk assessment and outcomes in patients with cardiovascular diseases. Cardiovascular therapy and prevention. 2015;14(1):53-62 (in Russian)]
  2. Посненкова О.М., Киселев А.Р., Коротин А.С., Генкал Е.Н., Гриднев В.И., Довгалевский П.Я. Публичный отчет о качестве медицинской помощи больным со стабильной ишемической болезнью сердца и хронической сердечной недостаточностью в 2013 году: данные регистра ишемической болезни сердца и хронической сердечной недостаточности по г. Саратову. ISSN 2313-0318, Кардио-ИТ 2014; 1: 0402 1/9 doi: 10.15275/cardioit.2014.0402 [Posnenkova O.M., Kisel'ev A.R., Korotin S.A., Genkal Ye.N., Gridnev V.I., Dovgalevsky P.Ya. Public report about the quality of medical care for patients with stable coronary artery disease and chronic heart failure in 2013: data register of coronary heart disease and chronic heart failure for the city of Saratov. (in Russian)]
  3. Панов А.В., Абесадзе И.Т., Алугишвили М.З., Вербило С.Л., Корженевская К.В., Кулешова Э.В., Лоховинина Н.Л., Дупляков Д.В., Хохлунов С.М., Крюков А.В., Либис Р.А., Исаева Е.Н., Басырова И.Р., Сафонова Д.В. Регистр больных, перенесших операцию АКШ при ИБС стабильного течения (программа РИКОШЕТ). Артериальная гипертензия. 2014;20(6):568-77. [Panov A.V., Abesadze I.T., Alugishvili M.Z., Verbilo S.L., Korzhenevskaya K.V., Kuleshova E.V., Lokhovinin N.L., Duplyakov D.V., Khokhlunov S.M., Kryukov A.V., Libis R.A., Isaeva Ye.N., Basyrova R.I., Safonova D.V. Register of patients undergoing cardiac surgery CABG in coronary artery disease, stable course (program RICOCHET). Hypertension. 2014;20(6):568-77 (in Russian)]
  4. Шальнова С.А., Оганов Р.Г., Стэг Ф.Г., Форд Й. от имени участников регистра CLARIFY. Ишемическая болезнь сердца. Современная реальность по данным всемирного регистра CLARIFY. Кардиология. 2013;8:28-33. [Shalnova S.A., Oganov R.G., Steg P.G., Ford I. on Behalf of Participants of the CLARIFY Registry. Coronary Artery Disease in Russia: Today's Reality Evidenced by the International CLARIFY Registry. Kardiologiia. 2013;8:28-33 (in Russian)]
  5. Nichols M., Townsend N., Scarborough P., Rayner M. Cardiovascular disease in Europe 2014: epidemiological update. Eur. Heart J. 2014;35(42):2950-9.
  6. Бокерия Л.А., Гудкова Р.Г. Сердечно-сосудистая хирургия. М.: Изд-во НЦССХ им. А.Н. Бакулева РАМН, 2010. [Bokeriya L.A., Gudkova R.G. Cardiovascular surgery. M.: publishing house of A.N. Bakulev Scientific center of cardiovascular surgery. RAMS, 2010 (in Russain)]
  7. Моисеев B.C. Сердечная недостаточность и достижения генетики. Сердечная недостаточность. 2000;4:121-30. [Moiseev V.S. Heart failure and genetics. Heart failure. 2000;4:121-30 (in Russain)]
  8. Vaur L., Danchin N., Genes N., Dubroca I., Etienne S., Ferrieres J., Cambou J.P. Epidemiology of myocardial infarction in France: therapeutic and prognostic implications of heart failure during the acute phase. Am. Heart J. 1999;137:4958.
  9. Хохлов А.Л., Лилеева Е.Г., Рыбачкова Ю.В., Сироткина А.М., Воронина Е.А. Значение определения полиморфизмов генов, отвечающих за активность ангиотензинпревращающего фермента у больных с артериальной гипертензией и хронической сердечной недостаточностью. Проблемы стандартизации в здравоохранении. 2012;3-4:41-4. [Khokhlov A.L., Lileev Ye.G., Rybachkova Yu.V., Sirotkina A.M., Voronina Ye.A. The significance of detection of polymorphisms in the genes responsible for the activity of angiotensin converting enzyme in patients with arterial hypertension and chronic heart failure. Problems of standardization in health care. 2012;3-4:41-4 (in Russain)]
  10. Pitt B., Remme W., Zannad F., Neaton J., Martinez F., Roniker B., Bittman R., Hurley S., Kleiman J., Gatlin M. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. New Engl. J. Med. 2003;348:1309-21.
  11. Szucs T.D., Holm M.V., Schwenkglenks M. et al. Costeffectiveness of eplerenone in patients with left ventricular dysfunction after myocardial infarction - an analysis of the EPHESUS study from a Swiss perspective. Cardiovasc. Drugs Ther. 2006;20(3):193-204.
  12. Hellermann J.P., Jacobsen S.J., Reeder G., Lopez-Jimenez F., Weston S.A., Roger V.L. Heart failure after myocardial infarction: prevalence of preserved left ventricular systolic function in the community. Am. Heart J. 2003;145:7428.
  13. The CAPRICORN Investigators. Effect of carvedilol on outcome after myocardial infarction in patients with left-ventricular dysfunction: the CAPRICORN randomized trial. Lancet. 2001;357:1385-90.
  14. McMurray J.J., Adamopoulos S., Anker S.D., Auricchio A., Bohm M., Dickstein K., Falk V., Filippatos G., Fonseca C., Gomez-Sanchez M.A., Jaarsma T., Kober L., Lip G.Y., Maggioni A.P., Parkhomenko A., Pieske B.M., Popescu B.A., Ronnevik P.K., Rutten F.H., Schwitter J., Seferovic P., Stepinska J., Trindade P.T., Voors A.A., Zannad F., Zeiher A.; ESC Committee for Practice Guidelines. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur. Heart J. 2012,33:1787-847.
  15. Heidenreich P.A., Albert N.M., Aller L.A. et al. American Heart Association Advocacy Coordinating Committee; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Clinical Cardiology; Council on Epidemiology and Prevention; Stroke Council. Forecasting the impact of heart failure in the United State: a policy statement from the American Heart Association. Ciro Heart Fail. 2013;6(3):606-9.
  16. Федеральные клинические рекомендации по диагностике и лечению хронической и острой сердечной недостаточности. М., 2013 [Federal clinical recommendations on diagnostics and treatment of chronic and acute heart failure. Moscow, 2013 (in Russian)]
  17. Tanai E., Frantz S. Pathophysiology of Heart Failure. Compr. Physiol. 2016;6(1):187-214.
  18. Guichard J.L., Clark D. 3rd, Calhoun D.A., Ahmed M.I. Aldosterone receptor antagonists: current perspectives and therapies. Vasc Health Risk Manag. 2013;9:321-31.
  19. Deinum J., Riksen N.P., Lenders J.W. Pharmacological treatment of aldosterone excess. Pharmacol Ther. 2015;154:120-33.
  20. Viengchareun S., Le Menuet D., Martinerie L., Munier M., Pascual-Le Tallec L., Lombes M. The mineralocorticoid receptor: insights into its molecular and (patho) physiological biology. Nucl. Recept. Signal. 2007;5:e012.
  21. Aroor A.R., Demarco V.G., Jia G., Sun Z., Nistala R., Meininger G.A., Sowers J.R. The role of tissue renin-angiotensin-aldosterone system in the development of endothelial dysfunction and arterial stiffness. Front. Endocrinol. 2013;4:161.
  22. Nagarajan V., Chamsi-Pasha M., Tang W.H. The role of aldosterone receptor antagonists in the management of heart failure: an update. Cleve Clin. J. Med. 2012;79(9):631-9.
  23. Карпов Ю.А., Сорокин Е.В. Антагонисты минералокортикоидных рецепторов при хронической сердечной недостаточности: показания к назначению и выбор препарата в свете современных знаний. АтмосферA. Новости кардиологии 2015;1:21-6. [Karpov Yu.A., Sorokin Ye.V. Antagonists of the mineralocorticoid receptor in chronic heart failure: indications and drug selection in the light of modern knowledge. Atmosphere. News of cardiology. 2015;1:21-6 (in Russain)]
  24. Armanini D., Sabbadin C., Dona G., Clari G., Bordin L. Aldosterone receptor blockers spironolactone and canrenone: two multivalent drugs. Expert Opin. Pharmacother. 2014;15(7):909-12.
  25. Dhillon S. Eplerenone: a review of its use in patients with chronic systolic heart failure and mild symptoms. Drugs. 2013;73(13):1451-62.
  26. Thanh N.X., Ezekowitz J.A., Tran D.T., Kaul P. Cost effectiveness of eplerenone for the treatment of systolic heart failure with mild symptoms in Alberta, Canada. Am. J. Cardiovasc Drugs. 2016 Jun 14. [Epub ahead of print]
  27. Yang J., Young M.J. Mineralocorticoid receptor antagonists-pharmacodynamics and pharmacokinetic differences. Curr. Opin. Pharmacol. 2016;27:78-85.
  28. Jeunemaitre X., Chatellier G., Kreft-Jais C., Charru A., DeVires C., Plouin P.F., Corvol P., Menard J. Efficacy and tolerance of spironolactone in essential hypertension. Am. J. Cardiol. 1987;60(10):820-5.
  29. Pelliccia F., Rosano G., Patti G., Volterrani M., Greco C., Gaudio C. Efficacy and safety of mineralocorticoid receptors in mild to moderate arterial hypertension. Int. J. Cardiol. 2015;200:8-1 1.
  30. Flack J.M., Oparil S., Pratt J.H., Roniker B., Garthwaite S., Kleiman J.H. et al. Efficacy and tolerability of eplerenone and losartan in hypertensive black and white patients. J. Am. Coll. Cardiol. 2003;41(7):1148-55.
  31. Krum H., Nolly H., Workman D., He W., Roniker B., Krause S., Fakouhi K. Efficacy of eplerenone added to renin-angiotensin blockade in hypertensive patients. Hypertension. 2002;40(2):1 17-23.
  32. van den Berg T.N., Rongen G.A., Frohlich G.M., Deinum J., Hausenloy D.J., Riksen N.P. The cardioprotective effects of mineralocorticoid receptor antagonists. Pharmacol. Ther. 2014;142(1):72-87.
  33. Pitt B., Reichek N., Willenbrock R., Zannad F., Phillips R.A., Roniker B. et al. Effects of eplerenone, enalapril, and eplerenone/enalapril in patients with essential hypertension and left ventricular trophy: the 4E-left ventricular hypertrophy study. Circulation. 2003;108(15):1831-8.
  34. Calhoun D.A., Jones D., Textor S., Goff D.C., Murphy T.P., Toto R.D., White A., Cushman W.C., White W., Sica D., Ferdinand K., Giles T.D., Falkner B., Carey R.M. Resistant hypertension: diagnosis, evaluation, and treatment: a scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Circulation. 2008;117(25):e510-26.
  35. Kumbhani D.J., Steg P.G., Cannon C.P., Eagle K.A., Smith S.C. Jr, Crowley K. et al. Resistant hypertension: a frequent and ominous finding among hypertensive patients with atherothrombosis. Eur. Heart J. 2013;34(16):1204-14.
  36. Strauch B., Zelinka T., Hampf M., Bernhardt R., Widimsky J. Jr. Prevalence of primary hyperaldosteronism in moderate to severe hypertension in the Central Europe region. J. Hum. Hypertens. 2003;17(5):349-52.
  37. Dahal K., Kunwar S., Rijal J., Alqatahni F., Panta R., Ishak N., Russell R.P. The effects of aldosterone antagonists in patients with resistant hypertension: a meta-analysis of randomized and nonrandomized studies. Am. J. Hypertens. 2015;28(1 1):1376-85.
  38. Calhoun D.A., White W.B. Effectiveness of the selective aldosterone blocker, eplerenone, in patients with resistant hypertension. J. Am. Soc. Hypertens. 2008;2(6):462-8.
  39. O'Gara P., Kushner F., Ascheim D. et al. ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction. A Report of the American College of Cardiology Foundation/American Heart Association. Task force on practice guidelines. Circulation. 2013;127:e362-e425.
  40. Yancy C.W., Jessup M., Bozkurt B., Butler J., Casey D.E. Jr., Drazner M.H., Fonarow G.C., Geraci S.A., Horwich T., Januzzi J.L., Johnson M.R., Kasper E.K., Levy W.C., Masoudi F.A., McBride P.E., McMurray J.J., Mitchell J.E., Peterson P.N., Riegel B., Sam F., Stevenson L.W., Tang W.H., Tsai E.J., Wilkoff B.L. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines. J. Am. Coll. Cardiol. 2013;62(16):147-239.
  41. Zannad F., McMurray J.J., Krum H., van Veldhuisen D.J., Swedberg K., Shi H., Vincent J., Pocock S.J., Pitt B. Eplerenone in patients with systolic heart failure and mild symptoms. New Engl. J. Med. 2011;364(1);11-21.
  42. Girerd N., Collier T., Pocock S., Krum H., McMurray J.J., Swedberg K., Van Veldhuisen D.J., Vincent J., Pitt B., Zannad F. Clinical benefits of eplerenone in patients with systolic heart failure and mild symptoms when initiated shortly after hospital discharge: analysis from the EMPHASIS-HF trial. Eur. Heart J. 2015;36(34):2310-7.
  43. Агеев Ф.Т., Даниелян М.О., Мареев В.Ю., Беленков Ю.В. Больные с хронической сердечной недостаточностью в российской амбулаторной практике: особенности контингента, диагностики и лечения (по материалам исследования ЭПОХА-ОХСН. Сердечная недостаточность. 2004;5( 1 ):4-7. [Ageev F.Т., Danielyan М.О., Mareev V.Yu., Belenkov Yu.V. Patients with chronic heart failure in the Russian ambulatory practice: contingent features, diagnosis and treatment (studies of EPOKHA-OKHSN. Heart failure. 2004;5(1):4-7 (in Russian)]
  44. Cohn J.N., Archibald D.G., Ziesche S., Ziesche S., Franciosa J.A., Harston W.E., Tristani F.E., Dunkman W.B., Jacobs W., Francis G.S., Flohr K.H., et al. Effect of vasodilator therapy on mortality in chronic congestive heart failure. N. Engl. J. Med. 1986;314:1547-52.
  45. Francis G.S. Neurohormonal control of heart failure. Clev. Clin. J. Med. 2011;78(Suppl 1):75-9.
  46. The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fraction and congestive heart failure. N. Engl. J. Med. 1991;325:293-302.
  47. Cohn J.N., Johnson G., Ziesche S., Cobb F., Francis G., Tristani F., Smith R., Dunkman W.B., Loeb H., Wong M. et al. A comparison of enalapril with hydralazine-isosorbide dinitrate in the treatment of chronic congestive heart failure. N. Engl. J. Med. 1991;32:303-10.
  48. Con J.N., Tognoni G. A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure. N. Engl. J. Med. 2001;345:1667-75.
  49. Struthers A.D., MacDonald T.M. Review of aldosterone- and angiotensin II-induced target organ damage and prevention.Cardiovasc. Rev. 2004;61:663-70.
  50. Cicoira M., Zanolla L., Franceschini L., Rossi A, Golia G, Zeni P, Caruso B, Zardini P. Relation of aldosterone "escape" despite angiotensin-converting enzyme inhibitor administration to impaired exercise capacity in chronic congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. Am. J. Cardiol. 2002;89:403-7.
  51. Rossignol P., Menard J., Fay R., Gustafsson F., Pitt B., Zannad F. Eplerenone survival benefits in heart failure patients post-myocardial infarction are independent from its diuretic and potassium sparing effects. Insights from an EPHESUS (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study) substudy. J. Am. Coll. Cardiol. 2011;58(19):1958-66.
  52. Zannad F., Gattis Stough W., Rossignol P., Bauersachs J., McMurray J.J., Swedberg K., Struthers A.D., Voors A.A., Ruilope L.M., Bakris G.L., O'Connor C.M., Gheorghiade M., Mentz R.J., Cohen-Solal A., Maggioni A.P., Beygui F., Filippatos G.S., Massy Z.A., Pathak A., Pina I.L., Sabbah H.N., Sica D.A., Tavazzi L., Pitt B. Mineralocorticoid receptor antagonists for heart failure with reduced ejection fraction: integrating evidence into clinical practice. Eur. Heart J. 2012;33(22):2782-95.
  53. Edelmann F., Wachter R., Schmidt A.G., Kraigher-Krainer E., Colantonio C., Kamke W. et al. Effect of spironolactone on diastolic function and exercise capacity in patients with heart failure with preserved ejection fraction: the Aldo-DHF randomized controlled trial. JAMA. 2013;309(8):781-91.
  54. Pitt B., Pfeffer M.A., Assmann S.F., Boineau R., Anand I.S., Claggett B., Clausell N., Desai A.S., Diaz R., Fleg J.L., Gordeev I., Harty B., Heitner J.F., Kenwood C.T., Lewis EF., O'Meara E., Probstfield J.L., Shaburishvili T., Shah S.J., Solomon S.D., Sweitzer N.K., Yang S., McKinlay S.M. Spironolactone for heart failure with preserved ejection fraction. N. Engl. J. Med. 2014;370(15):1383-92.
  55. Wilson Tang W.H., Marcy T.R., Ripley T.L. Aldosterone antagonists in the treatment of heart failure. Am. J. Health Syst. Pharm. 2006;63(1):49-58.
  56. Miller A.B. Aldosterone antagonism in heart failure. Vasc. Health Risk Manag. 2007;3(5):605-9.
  57. Prisant L.M., Chin E. Gynecomastia and hypertension. J. Clin. Hypertens (Greenwich). 2005;7(4):245-8.
  58. Rastogi S., Rodriguez J.J., Kapur V., Schwarz E.R. Why do patients with heart failure suffer from erectile dysfunction? A critical review and suggestions on how to approach this problem. Int. J. Impot. Res. 2005;17:25-36.
  59. Mandras S.A., Uber P.A., Mehra M.R. Sexual activity and chronic heart failure. Mayo Clin. Proc. 2007;82(10):1203-10.

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