Reply Mineralocorticoid Receptor Antagonism in Acute Myocardial Infarction: Who Benefits?

The letter by Drs. Weir and Petrie points to the hypothetic benefit of mineralocorticoid receptor blockade (MRA) in preventing left ventricular remodeling and reducing mortality in patients with myocardial infarction (MI) but preserved left ventricular function. Although the ALBATROSS (Aldosterone Lethal Effects Blockade in Acute Myocardial Infarction Treated With or Without Reperfusion to Improve Outcome and Survival at Six Months Follow-up) study(1) failed to demonstrate a benefit of MRA in the global MI population, it reported a possible reduction of mortality only in the ST-segment elevation MI subgroup (1,229 of 1,603 patients). The potential mechanisms of such an effect on mortality in ST-segment elevation MI may be a prevention of the arterial occlusion-related adverse remodeling and/or potentially lethal arrhythmia, as suggested by the authors.
Source: Journal of the American College of Cardiology - Category: Cardiology Source Type: research