Problems and possibilities in eplerenone therapy
Jász-Nagykun-Szolnok Megyei Hetényi Géza Kórház-Rendelőintézet, Kardiológiai Szakrendelő, Szolnok
The author regards the results of mega-trials executed with eplerenone as starting point. He is considering the opportunities of proceeding in different directions: how early is it worthy to initiate eplerenone therapy in acute myocardial infarction and why? Does this approach have a risk? What is the indication of possible reserve (benefit) to initiate this therapy even earlier compared to protocols of megatrials? Is the sequence of usage classical eplerenone addition to ACE inhibitor cascade interchangeable? What kind of arguments supports this concept? The side effect profile and pharmacokinetics of spironolactone and eplerenone are different. Therefore, these therapeutical regiments could create practical clinical consequences.