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Date of download: 7/5/2016 Copyright © The American College of Cardiology. All rights reserved. From: Early Aldosterone Blockade in Acute Myocardial Infarction:

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Presentation on theme: "Date of download: 7/5/2016 Copyright © The American College of Cardiology. All rights reserved. From: Early Aldosterone Blockade in Acute Myocardial Infarction:"— Presentation transcript:

1 Date of download: 7/5/2016 Copyright © The American College of Cardiology. All rights reserved. From: Early Aldosterone Blockade in Acute Myocardial Infarction: The ALBATROSS Randomized Clinical Trial J Am Coll Cardiol. 2016;67(16):1917-1927. doi:10.1016/j.jacc.2016.02.033 Patient Enrollment and Follow-Up Flow Chart Patients were randomized to mineralocorticoid receptor antagonist (MRA) therapy or standard care. Figure Legend:

2 Date of download: 7/5/2016 Copyright © The American College of Cardiology. All rights reserved. From: Early Aldosterone Blockade in Acute Myocardial Infarction: The ALBATROSS Randomized Clinical Trial J Am Coll Cardiol. 2016;67(16):1917-1927. doi:10.1016/j.jacc.2016.02.033 Primary Outcome Per the Kaplan-Meier estimate, there was no difference between the arms in terms of the primary outcome, which was a composite of death, resuscitated cardiac arrest, significant ventricular arrhythmia, indication for implantable defibrillator, or new or worsening heart failure. CI = confidence interval; MRA = mineralocorticoid receptor antagonist. Figure Legend:

3 Date of download: 7/5/2016 Copyright © The American College of Cardiology. All rights reserved. From: Early Aldosterone Blockade in Acute Myocardial Infarction: The ALBATROSS Randomized Clinical Trial J Am Coll Cardiol. 2016;67(16):1917-1927. doi:10.1016/j.jacc.2016.02.033 Kaplan-Meier Estimates of Death Overall, there was no difference in death from any cause among all patients (A), but the MRA regimen significantly reduced mortality odds in patients with ST-segment elevation myocardial infarction (B). Abbreviations as in Figure 2. Figure Legend:

4 Date of download: 7/5/2016 Copyright © The American College of Cardiology. All rights reserved. From: Early Aldosterone Blockade in Acute Myocardial Infarction: The ALBATROSS Randomized Clinical Trial J Am Coll Cardiol. 2016;67(16):1917-1927. doi:10.1016/j.jacc.2016.02.033 Subgroup Analyses: Primary Outcome Results were consistent across pre-specified subgroups. ACE = angiotensin-converting enzyme inhibitor; ARB = angiotensin receptor blocker; BB = beta-blocker; BMI = body mass index; MRA = mineralocorticoid receptor antagonist; NSTEMI = non-ST- segment elevation myocardial infarction; PCI = percutaneous coronary intervention; STEMI = ST-segment elevation myocardial infarction. Figure Legend:

5 Date of download: 7/5/2016 Copyright © The American College of Cardiology. All rights reserved. From: Early Aldosterone Blockade in Acute Myocardial Infarction: The ALBATROSS Randomized Clinical Trial J Am Coll Cardiol. 2016;67(16):1917-1927. doi:10.1016/j.jacc.2016.02.033 Subgroup Analyses: Mortality The type of myocardial infarction in regard to ST-segment elevation significantly impacted mortality. Abbreviations as in Figure 4. Figure Legend:

6 Date of download: 7/5/2016 Copyright © The American College of Cardiology. All rights reserved. From: Early Aldosterone Blockade in Acute Myocardial Infarction: The ALBATROSS Randomized Clinical Trial J Am Coll Cardiol. 2016;67(16):1917-1927. doi:10.1016/j.jacc.2016.02.033 Aldosterone Blockade in MI: Mortality Outcomes Although use of mineralocorticoid receptor antagonists (MRA) significantly reduced mortality in post–myocardial infarction (MI) patients with heart failure in the landmark randomized EPHESUS (Eplerenone Post-Acute MI Heart Failure Efficacy and Survival) study, mineralocorticoid receptor blockade did not decrease mortality compared to standard care in the ALBATROSS (Aldosterone Lethal effects Blocked in Acute MI Treated with or without Reperfusion to improve Outcome and Survival at Six months follow-up) trial in acute MI patients irrespective of the presence of heart failure (HF) or left ventricular dysfunction. CI = confidence interval; HR = hazard ratio; IV = intravenous; K+ = potassium; NSTEMI = non–ST-segment elevation myocardial infarction; RR = relative risk; STEMI = ST-segment elevation myocardial infarction. Figure Legend:


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