Eplerenone Insights on Aldosterone Dynamics: EPHESUS Revisited | JACC Baran
JACC Global19 Aug 2025

Eplerenone Insights on Aldosterone Dynamics: EPHESUS Revisited | JACC Baran

Hosts Mitsuaki Sawano, MD, Kentaro Ejiri, MD, and Satoshi Shoji, MD, welcome Dr. Masatake Kobayashi of Tokyo Medical University to explore the interaction between aldosterone and mineralocorticoid receptor antagonists (MRAs) in a post hoc analysis of the EPHESUS trial. Dr. Kobayashi reviews findings from a cohort of post–myocardial infarction patients with left ventricular dysfunction or heart failure in whom aldosterone levels were measured. In the placebo group, higher baseline aldosterone or an increase over one month was associated with cardiovascular death or heart failure hospitalization, whereas these associations were not observed in the eplerenone group. The analysis offers descriptive evidence on how MRA therapy may modify the relationship between aldosterone and outcomes, even in a population with relatively low aldosterone levels compared to prior studies. The discussion extends to implications for GDMT optimization in Japan, as well as distinctions among spironolactone, eplerenone, and the emerging non-steroidal MRA, finerenone.

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Episoder(93)

ICI Myocarditis: Does Timing Define the Disease? | JACC Baran

ICI Myocarditis: Does Timing Define the Disease? | JACC Baran

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ICI Myocarditis: Does Timing Define the Disease? | JACC Baran

ICI Myocarditis: Does Timing Define the Disease? | JACC Baran

Is immune checkpoint inhibitor (ICI)-associated myocarditis the same disease when it occurs early versus months after starting cancer therapy? Host Mitsuaki Sawano, MD, and co-host Shun Kohsaka, MD, w...

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Does PFA Reach the Vein of Marshall? | JACC Baran

Does PFA Reach the Vein of Marshall? | JACC Baran

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27 Okt 36min

A SELUTION to Paclitaxel DCB Complications in PAD? | JACC Baran

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20 Okt 28min

Proteomics in Action: Finding the Right Drug Targets for Ischemic Heart Disease | JACC Baran

Proteomics in Action: Finding the Right Drug Targets for Ischemic Heart Disease | JACC Baran

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13 Okt 35min

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PET Unmasks CMD: The Hidden Risk Behind Normal Perfusion | JACC Baran

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6 Okt 36min

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29 Sep 39min

PFA Changes the Game and the AT Circuit | JACC Baran

PFA Changes the Game and the AT Circuit | JACC Baran

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