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New Clinical Aspects of Eplerenone Use in Clinical Practice

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The problem of the discrepancy between convincing evidences of the effectiveness of the use of mineralocorticoid receptor antagonists in patients with heart failure with reduced left ventricular ejection fraction and insufficiently frequent their use in clinical practice for the treatment of these patients is considered in the article. Experts opinions on the reasons for this discrepancy are also presented. New data on the effectiveness of the use of the mineralocorticoid receptor antagonist, eplerenone, in some clinical situations identified in the analysis of subgroups of participants in a large randomized clinical trial EMPHASIS-HF are discussed. The main goal of this study was to evaluate the efficacy of eplerenone compared with placebo in patients with heart failure and reduced left ventricular function. In addition, experimental animal studies, which may indicate the pleiotropic effects of eplerenone in patients with vascular diseases, are presented. The new data on the effectiveness of eplerenone in subgroups of patients with heart failure and certain characteristics may be an additional reason to draw the attention of physicians to the benefits of its use and, accordingly, its more frequent application in clinical practice for the treatment of patients with clear indications for this therapy.

About the Authors

S. R. Gilyarevskiy
Russian Medical Academy of Continuing Professional Education
Russian Federation
Sergey R. Gilyarevskiy – MD, PhD, Professor, Chair of Clinical Pharmacology and Therapy

N. G. Bendeliani
A.N. Bakulev National Medical Research Center of Cardiovascular Surgery
Russian Federation
Nana G. Bendeliani – MD, PhD, Senior Researcher, Scientific-Advisory Department, Institute of Coronary and Vascular Surgery, Consultative and Diagnostic Center

M. V. Golshmid
Russian Medical Academy of Continuing Professional Education
Russian Federation

Maria V. Golshmid – MD, PhD, Associate Professor, Chair of Clinical Pharmacology and Therapy

Barrikadnaya ul. 2/1, Moscow, 125993 

I. M. Kuzmina
Sklifosovsky Research Institute of Emergency Medicine
Russian Federation

Irina M. Kuzmina – MD, PhD, Leading Researcher, Department of Emergency Cardiology 

Bolshaya Sukharevskaya pl. 3, Moscow, 129090 


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For citation:

Gilyarevskiy S.R., Bendeliani N.G., Golshmid M.V., Kuzmina I.M. New Clinical Aspects of Eplerenone Use in Clinical Practice. Rational Pharmacotherapy in Cardiology. 2018;14(4):612-620. (In Russ.)

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