NYMC Faculty Publications
An Overview of Mineralocorticoid Receptor Antagonists as a Treatment Option for Patients With Heart Failure: The Current State-Of-The-Art and Future Outlook
Author Type(s)
Faculty
Journal Title
Expert Opinion on Pharmacotherapy
First Page
1737
Last Page
1751
Document Type
Article
Publication Date
10-1-2022
Department
Medicine
Abstract
INTRODUCTION: Mineralocorticoid receptor antagonists (MRAs) improve cardiovascular outcomes in patients with heart failure. These benefits of MRAs vary in different heart failure populations based on left ventricular ejection fraction and associated comorbidities. AREAS COVERED: We define the pharmacologic properties of MRAs and the pathophysiological rationale for their utility in heart failure. We outline the current literature on the use of MRAs in different heart failure populations, including reduced and preserved ejection fraction (HFrEF/HFpEF) and acute heart failure decompensation. Finally, we describe the limitations of currently available data and propose future directions of study. EXPERT OPINION: While there is strong evidence supporting the use of MRAs in HFrEF, evidence in patients with HFpEF or acute heart failure is less definitive. Comorbidities such as obesity or atrial fibrillation could be clinical modifiers of the response to MRAs and potentially alter the risk/benefit ratio in these subpopulations. Emerging evidence for new non-steroidal MRAs reveal promising preliminary results that, if confirmed in large randomized clinical trials, could favor a change in clinical practice.
Recommended Citation
Lorente-Ros, M., Aguilar-Gallardo, J. S., Shah, A., Narasimhan, B., & Aronow, W. S. (2022). An Overview of Mineralocorticoid Receptor Antagonists as a Treatment Option for Patients With Heart Failure: The Current State-Of-The-Art and Future Outlook. Expert Opinion on Pharmacotherapy, 23 (15), 1737-1751. https://doi.org/10.1080/14656566.2022.2138744
