[Antialdosteronic agents: their role in heart failure]. / Fármacos antialdosterónicos: su papel en la insuficiencia cardíaca.
Med Clin (Barc)
; 130(1): 30-4, 2008 Jan 19.
Article
em Es
| MEDLINE
| ID: mdl-18221644
ABSTRACT
Antialdosteronic treatment is used again in heart failure. It pursues the neurohormonal blockage of the final effector of the renin-angiotensin axis. Employed agents include espironolactone and, more recently, eplerenone (which lacks the adverse effects of the former such as gynecomastia). They have beneficial effects both in advanced heart failure (NYHA class III or IV) and heart insufficiency appearing after myocardial infarction. It remains to be demonstrated if they are also effective in less advanced chronic heart insufficiency (NYHA class II) and diastolic cardiac failure, though several ongoing studies are testing this benefit. Trials with antialdosteronics have shown improvements in overall mortality, even when patients were already receiving full therapy including ACEIs and, lastly, beta-blockers. The limitation of antialdosteronics is hyperkaliemia, which occurs more frequently in the general population than in patients enrolled in clinical trials, since the former is an elderly population with greater comorbility and submitted to less controls. Therefore, antialdosteronic treatment cannot be administered in some cases (especially if there is a renal function impairment) and a careful monitoring of the serum ionnograme is mandatory.
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Base de dados:
MEDLINE
Assunto principal:
Antagonistas de Receptores de Mineralocorticoides
/
Insuficiência Cardíaca
Limite:
Humans
Idioma:
Es
Ano de publicação:
2008
Tipo de documento:
Article