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Eplerenone


Presentation

  • A 47-year-old woman presented with hypokalemia (2.4 mmol/L). She also had hypomagnesemia, hypocalciuria, and hyperreninemic hyperaldosteronism. Sequence analysis revealed a compound heterozygous mutation, R655C and R955Q, in the SLC12A3 gene.[ncbi.nlm.nih.gov]
  • A class effect is likely present and thus spironolactone is frequently used instead of eplerenone due to cost concerns, although there is no direct data to support this practice.[healio.com]

Workup

Hypocalciuria
  • She also had hypomagnesemia, hypocalciuria, and hyperreninemic hyperaldosteronism. Sequence analysis revealed a compound heterozygous mutation, R655C and R955Q, in the SLC12A3 gene. These findings were compatible with Gitelman's syndrome (GS).[ncbi.nlm.nih.gov]
Hepatocellular Carcinoma
  • carcinoma growth and angiogenesis in mice , Hepatology Research , 40 , 5 , (540-549) , (2010) .[doi.org]

Treatment

  • Treatment Duchenne's Muscular Dystrophy (DMD) 1 3 Completed Treatment Heart Failure 2 3 Completed Treatment High Blood Pressure (Hypertension) 2 3 Completed Treatment Hypertension,Essential 2 3 Recruiting Treatment End-Stage Renal Disease (ESRD) 1 3[drugbank.ca]
  • DESIGN AND METHODS: This prospective multi-center study included 29 patients with newly diagnosed PA evaluated before and 1 year after treatment initiation, and a second cohort including 119 patients who were evaluated 5.3 and 6.8 years after treatment[ncbi.nlm.nih.gov]

Prognosis

  • […] factors to cause organ damage during an acute phase of heart failure (HF), and many reports have demonstrated that patients with acute decompensated HF (ADHF) have high blood aldosterone concentrations, and the high aldosterone concentrations predict poor prognosis[ncbi.nlm.nih.gov]
  • Carole Nadin Core Medical Publishing, Knutsford, UK Introduction: Heart failure is a frequent complication after acute myocardial infarction (MI) and carries a poor prognosis.[dovepress.com]
  • “Compared with spironolactone, eplerenone may be more useful for treatment of CHF patients from the perspective of insulin resistance and cortisol levels, which were related to poor prognosis.” Am Heart J 2010;160:915-921.[thedoctorschannel.com]

Etiology

  • Alternatively, it is plausible that mineralocorticoid receptor antagonism may add an adjunctive efficacy in the setting of subretinal fluid from both etiologies, particularly given a potentially shared choroidal pathologic origin.[karger.com]
  • Demographics: Age 68.7 years, female 22.7%, white race 82.9%, asian race 11.6%, black race 2.7% Baseline health data: HR 72 BPM, BP 124/75 mmHg, LVEF 26.2%, QRS duration 121 msec, BMI 27.5 kg/m 2 Heart failure etiology: Ischemic cardiomyopathy 69.7%,[wikijournalclub.org]
  • The precise etiology of CSC remains unknown, but the pathogenesis appears to involve dysfunction of the choroid (the major blood vessel network serving the outer portion of the retina) and RPE ( Prunte 1996 ).[doi.org]

Epidemiology

  • Internal Medicine, Division of Nephrology pOffice of the Vice Rector for Teaching and Studies, Medical University of Graz, Graz, Austria qDepartment of Medicine, Division of Nephrology, University Hospital Heidelberg, Heidelberg, Germany rDepartment of Epidemiology[ncbi.nlm.nih.gov]
  • Jan 18: No recent reports of development identified, and not listed in Pfizer product pipeline Jan 16: No recent reports of development identified, and not listed in Pfizer product pipeline [4] · Category Pharmacology Selective aldosterone inhibitor Epidemiology[sps.nhs.uk]
  • There is no available epidemiological information on long-term survival in patients developing heart failure as a result of MI.[bjcardio.co.uk]
  • United Kingdom § Department of Emergency and Cardiovascular Medecine , Sahlgrenska Academy , University of Gothenburg , Gothenburg, Sweden ‖ Department of Cardiology , Thorax Center , University Medical Center , Groningen, the Netherlands ¶ Department of Epidemiology[onlinejacc.org]
  • United Kingdom § Department of Emergency and Cardiovascular Medecine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden ‖ Department of Cardiology, Thorax Center, University Medical Center, Groningen, the Netherlands ¶ Department of Epidemiology[content.onlinejacc.org]
Sex distribution
Age distribution

Pathophysiology

  • BACKGROUND: There is no proven pharmacological strategy for the treatment of the failing systemic right ventricle (SRV) but myocardial fibrosis may play a role in its pathophysiology.[ncbi.nlm.nih.gov]
  • Moreover, genetic susceptibility seems to play an important role in the pathophysiology of CSCR and genetic polymorphisms have been associated with CSCR [ 11 – 13 ].[journalretinavitreous.biomedcentral.com]
  • Abstract Overactivation of mineralocorticoid receptor pathways has been implicated in the pathophysiology of central serous chorioretinopathy (CSCR).[karger.com]
  • Discussion Activation of the mineralocorticoid receptor by both aldosterone and cortisol plays an important role in the pathophysiology of heart failure. Mineralocorticoid receptors are overexpressed in the failing heart. Despite therapy with ACE inhibitors[slideshare.net]
  • The pathophysiology of aldosterone in the cardiovascular system . Ann. NY Acad. Sci. 970 , 89–100 (2002). 5. McMahon, E. G. Recent studies with eplerenone, a novel selective aldosterone receptor antagonist . Curr. Opin.[nature.com]

Prevention

  • The current pilot study evaluated whether it can be used to prevent the growth and rupture of cerebral aneurysms in hypertensive patients.[ncbi.nlm.nih.gov]
  • Chronic Renal Failure (CRF) 1 4 Completed Prevention Myocardial Infarction 1 4 Completed Treatment Atrial Switch Procedure / Transposition of the Great Vessels / Transposition of the Great Vessels With Atrial Switch 1 4 Completed Treatment Chronic Central[drugbank.ca]
  • ) and a low ASCVD risk (10-year risk 1200 For secondary prevention in adults with known cardiovascular disease or for primary prevention in those at higher risk for ASCVD (10-year risk 10%), ACC/AHA recommend initiation of antihypertensive drug therapy[drugs.com]

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