Peer Reviewed

1

Document Type

Contribution to Book

Publication Date

5-9-2019

Keywords

Coronary Artery Disease, Myocardial Infarction, Heart Failure

Comments

The original book chapter is available at https://www.intechopen.com

Abstract

Affecting sodium reabsorption and potassium excretion in the kidney, mineralocorticoid receptor antagonists (MRA) were originally developed as antihypertensive drugs. After several large clinical trials, the concept of MR blockade has nowadays become a main treatment paradigm in heart failure with reduced ejection fraction (HFrEF) and for patients after myocardial infarction (MI) with left ventricular (LV) dysfunction. Recent analyses also point to a beneficial effect of early MRA treatment in patients with acute MI without LV dysfunction, however, there is no clear evidence yet. Although promising data from preclinical settings suggest that MRAs mediate favorable anti-atherogenic effects, clinical studies in patients with stable coronary artery disease (CAD) have not been able to detect differences of hard clinical outcomes. The concept might still be pursued using the most recent MRA, like the non-steroidal MR antagonist finerenone, and larger clinical trials need to be performed. Here, we review the current impact of MRA in patients with CAD and focus on the conflicting evidence of preclinical and clinical data in patients with stable CAD and preserved ejection fraction and summarize the current indications for MRA in these patients according to the guidelines.

Disciplines

Medical Molecular Biology | Medical Sciences

Citation

Zwadlo C, Bauersachs J. Mineralocorticoid Receptor Antagonists in the Treatment of Coronary Artery Disease, Myocardial Infarction and Heart Failure. In: Harvey B, Jaisser F, editors. Aldosterone-Mineralocorticoid Receptor - Cell Biology to Translational Medicine: InTechOpen; 2019.

DOI Link

10.5772/intechopen.87224

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

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