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(69)

HFpEF and HFmrEF: Can KCCQ-12 Replace KCCQ-23? | JACC Baran

HFpEF and HFmrEF: Can KCCQ-12 Replace KCCQ-23? | JACC Baran

Hosts Mitsuaki Sawano, MD, Kentaro Ejiri, MD, and Nobuhiro Ikemura, MD welcome Dr. Yasuhiro Hamatani, MD (Brigham and Women’s Hospital) to discuss his study, “Interchangeability of the KCCQ-12 and KCC...

26 Mai 33min

Can AI Predict AF Recurrence After Cardioversion? | JACC Baran

Can AI Predict AF Recurrence After Cardioversion? | JACC Baran

Hosts Mitsuaki Sawano, MD, and Satoshi Shoji, MD welcome Dr. Keisuke Usuda, MD (Massachusetts General Hospital / Broad Institute of MIT and Harvard) to discuss his JACC: Clinical Electrophysiology stu...

19 Mai 32min

Mitral Stenosis: Beyond Rheumatic Disease | JACC Baran

Mitral Stenosis: Beyond Rheumatic Disease | JACC Baran

Hosts Mitsuaki Sawano, MD, Kentaro Ejiri, MD, and Nobuhiro Ikemura, MD welcome Dr. Nahoko Kato, MD, PhD (Tokyo Bay Urayasu Ichikawa Medical Center) and Dr. Hiroyuki Okura, MD, PhD (Gifu University) to...

12 Mai 31min

AF Ablation and the Brain: Does It Improve Blood Flow and Cognition? | JACC Baran

AF Ablation and the Brain: Does It Improve Blood Flow and Cognition? | JACC Baran

Hosts Mitsuaki Sawano, MD, Satoshi Shoji, MD, Nobuhiro Ikemura, MD, and Hiroyuki Sato, MD welcome Dr. Tasuku Yamamoto, MD (Cleveland Clinic) to discuss his JACC: Clinical Electrophysiology study, “Neu...

5 Mai 41min

Acute PE in Practice: An APAC View on the New AHA/ACC Guideline | JACC Baran

Acute PE in Practice: An APAC View on the New AHA/ACC Guideline | JACC Baran

Hosts Mitsuaki Sawano, MD, and Shun Kohsaka, MD, welcome Dr. Yugo Yamashita, MD (Kyoto University) to discuss the newly released 2026 AHA/ACC Guideline for Acute Pulmonary Embolism and its accompanyin...

28 Apr 42min

Marfan Syndrome: Timing Surgery Through Genetics | JACC Baran

Marfan Syndrome: Timing Surgery Through Genetics | JACC Baran

Hosts Mitsuaki Sawano, MD, welcome Dr. Yuki Kawashima, MD and Dr. Ryo Inuzuka, MD (The University of Tokyo) to discuss their JACC study on how genetic variants in FBN1 can predict the timing and risk ...

21 Apr 36min

Unraveling HCM Heterogeneity Using Circulating microRNAs | JACC Baran

Unraveling HCM Heterogeneity Using Circulating microRNAs | JACC Baran

Hosts Mitsuaki Sawano, MD, Shun Kohsaka, MD, and Nobuhiro Ikemura, MD welcome Dr. Yuichi J. Shimada (Columbia University) to discuss his ACC presentation on plasma microRNA profiling in hypertrophic c...

14 Apr 27min

Chagas Cardiomyopathy — Epidemiology Through Modern Clinical Trials | JACC Baran

Chagas Cardiomyopathy — Epidemiology Through Modern Clinical Trials | JACC Baran

Hosts Mitsuaki Sawano, MD, Shun Kohsaka, MD, and Nobuhiro Ikemura, MD welcome Dr. Ryohei Ono, MD, PhD (University of Glasgow / Chiba University) to discuss his simultaneously published JACC study anal...

7 Apr 19min

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