6/28/23, 9:58 PM EPHESUS Pathway Feedback Search Clinical Topics Home Studies EPHESUS EPHESUS Disease Disease Non-ST-elevation myocardial inf ST-elevation myocardial infarction Trial question What is the role of eplerenone in patients with acute myocardial infarction complicated by LV dysfunction and HF? Study design Multi-center Double blinded RCT Population Characteristics of study participants 29.0% female N = 6632 71.0% male 6632 patients (1918 female, 4714 male) Inclusion criteria: patients with acute myocardial infarction complicated by LV dysfunction and HF Key exclusion criteria: use of potassium-sparing diuretics, a serum creatinine concentration > 2.5 mg/dL, and a serum potassium concentration > 5.0 mmol/L before randomization Interventions N=3319 eplerenone (25 mg per day initially, titrated to a maximum of 50 mg per day) N=3313 placebo (matching placebo) Primary outcome Cardiovascular death or hospitalization for cardiovascular events 30.0 % 30 26.7 22 5 % https://web.pathway.md/studies/recGOrkaW6SuoQYv4 1/2 6/28/23, 9:58 PM 22.5 % EPHESUS Pathway 15.0 % Significant decrease 7.5 % NNT = 30 0.0 % Eplerenone Placebo Significant decrease in cardiovascular death or hospitalization for cardiovascular events (26.7% vs. 30%; RR 0.87, 95% CI 0.79 to 0.95) Secondary outcomes Significant decrease in death from any cause or hospitalization (52% vs. 55%; RR 0.92, 95% CI 0.86 to 0.98) Safety outcomes Significant differences in serious hyperkalemia (5.5% vs. 3.9%, p = 0.002) and hypokalemia (8.4% vs. 13.1%, p < 0.001). Conclusion In patients with acute myocardial infarction complicated by LV dysfunction and HF, eplerenone was superior to placebo with respect to cardiovascular death or hospitalization for cardiovascular events. Reference Pitt B, Remme W, Zannad F et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 2003 Apr 3;348(14):1309- 21. Open reference URL https://web.pathway.md/studies/recGOrkaW6SuoQYv4 2/2