[Aldosterone receptor antagonist use after myocardial infarction. Data from the REICIAM registry].

Abstract

INTRODUCTION AND OBJECTIVES:

Although of proven effectiveness, there are no data available on the patterns of aldosterone antagonists use in the setting of acute myocardial infarction.

METHODS:

The REICIAM registry is a prospective study designed to provide data regarding the incidence and management of heart failure after acute myocardial infarction. The aim of the present analysis was to determine the patterns of aldosterone antagonists use in this situation.

RESULTS:

From a total of 2703 patients with acute myocardial infarction, 416 (15.4%) were considered optimal candidates to receive aldosterone antagonists, but only 228 (54.8%) received the treatment. The independent factors associated with their administration were male sex (odds ratio=2.06; 95% confidence interval, 1.23-3.49; P=.006), absence of prior kidney failure (odds ratio=3.31; 95% confidence interval, 1.26-9.06; P=.02), presentation with ST elevation (odds ratio=2.01; 95% confidence interval, 1.21-3.35; P=.007) and the development of malignant arrhythmias (odds ratio=2.75; 95% confidence interval, 1.3-6.05; P=.009). The lower the ejection fraction, the higher the likelihood of receiving aldosterone antagonists. The major independent predictor for receiving aldosterone antagonists was the prescription of diuretics during hospitalization (odds ratio=7.11; 95% confidence interval, 3.72-14.23; P <.00001), but also treatment with clopidogrel, beta-blockers, and statins. Although patients treated with aldosterone antagonists had a higher risk profile, they had a better 30-day survival rate than untreated patients (88.3% and 77.7% respectively; P <.0001).

CONCLUSIONS:

The use of aldosterone antagonists in post-acute myocardial infarction is only 54.8% of the optimal candidates. Their use is associated with male sex, a higher risk profile, and the use of diuretics and other drugs of proven efficacy in secondary prevention.

• Authors: Esteban López-de-Sá, Angel Martínez, Manuel Anguita, David Dobarro, Manuel Jiménez-Navarro, en representación de los investigadores del REICIAM
• Journal: Revista espanola de cardiologia (Rev Esp Cardiol) Vol. 64 Issue 11 Pg. 981-7 (Nov 2011) ISSN: 1579-2242 [Electronic] Spain
• Vernacular Title: Uso de antagonistas de los receptores de aldosterona tras el infarto de miocardio. Datos del registro REICIAM.
• PMID: 21924809 (Publication Type: English Abstract, Journal Article, Multicenter Study)
• Copyright: Copyright © 2011 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Chemical References

• Cardiovascular Agents
• Mineralocorticoid Receptor Antagonists

Topics

• Adult
• Aged
• Cardiovascular Agents (therapeutic use)
• Data Interpretation, Statistical
• Drug Prescriptions (statistics & numerical data)
• Drug Utilization
• Female
• Humans
• Male
• Middle Aged
• Mineralocorticoid Receptor Antagonists (therapeutic use)
• Myocardial Infarction (complications, drug therapy, epidemiology)
• Odds Ratio
• Prospective Studies
• Registries
• Sex Factors
• Spain (epidemiology)