login
  Password reminder
Cardiovascular News
Contact the editor Visit Cardiovascular News Twitter feed Visit Cardiovascular News Facebook page
 

New European guidelines set to benefit heart failure patients in the UK


Thursday, 07 Jun 2012 11:13

The new guidelines state that the combination of “an ACE inhibitor [or angiotensin receptor blocker (ARB)], a beta-blocker, and an MRA, are fundamentally important in modifying the course of systolic heart failure and should at least be considered in every patient”.

 

This update provides welcome guidance to UK clinicians as it builds upon existing NICE guidance developed before the EMPHASIS-HF trial results were published.

 

Results of the EMPHASIS-HF trial showed that eplerenone (Inspra, Pfizer) reduces the risk of cardiovascular death or heart failure hospitalisation by more than a third compared to placebo in heart failure patients already receiving current standard therapy (RRR = 37%, p<0.001; ARR = 7.6%, p<0.001). These results were achieved against a quality of background therapy seldom seen in day to day clinical practice – 94% of patients in the eplerenone arm were also receiving an ACE inhibitor and over 86% were receiving a beta-blocker – highlighting the additive benefit of MRAs over standard therapy.

 

“The inclusion of eplerenone and mineralocorticoid receptor antagonists in the latest ESC guidelines is a significant step in making these life saving and cost effective treatments available to patients that need them,” said Martin Cowie, professor of Cardiology at Imperial College and consultant cardiologist at the Royal Brompton Hospital, London, UK. “Eplerenone should be offered to all eligible patients who continue to exhibit symptoms as it has been shown not only to save lives but, importantly, help keep patients out of hospital.”

 

Eplerenone has also been shown to reduce the likelihood of patients being admitted to hospital (due to heart failure) by over 40% (RRR 42%, p<0.001; ARR 6.8%, p<0.001). Hospitalisation due to HF is commonplace and every heart failure emergency admission costs at least £2,400.

 

Health economic analysis of eplerenone in patients with chronic heart failure (NYHA class II) have shown that eplerenone as an add-on to standard optimal therapy is highly cost-effective compared to standard therapy alone, with an incremental cost per Quality Adjusted Life Year (QALY) gained of £3,534, well below the lower £20,000 threshold typically viewed by NICE as representing good value for money.

 

Eplerenone has recently been approved in the UK to reduce the risk of cardiovascular mortality and morbidity in adult patients with NYHA class II (chronic) heart failure and left ventricular systolic dysfunction (left ventricular ejection fraction ≤30%), in addition to standard optimal therapy. It is also indicated to treat patients with heart failure and left ventricular ejection fraction ≤ 40%, after recent myocardial infarction again, alongside standard therapy.




Add New Comment

Most popular


Medtronic completes acquisition of Covidien
Tuesday, 27 Jan 2015
Under the terms of the acquisition agreement, Medtronic Inc and Covidien plc are now combined under Medtronic plc. Medtronic completes acquisition of Covidien

Transapical TAVI can be performed with comparable results to transfemoral TAVI in high-volume centres
Friday, 16 Jan 2015
Results from a registry of 1,000 patients undergoing transcatheter aortic valve implantation (TAVI) in a high-volume centre do not indicate a significant difference in the rates of short- and long-... Transapical TAVI can be performed with comparable results to transfemoral TAVI in high-volume centres

Arteriovenous anastomosis creation brings blood pressure down
Friday, 06 Feb 2015
The ROX CONTROL HTN, an international randomised controlled trial, published online ahead of print in The Lancet in late January, has demonstrated that creation of a central arteriovenous anastomosis ... Arteriovenous anastomosis creation brings blood pressure down

Features


Exploring new transcatheter options for the mitral valve
Thursday, 19 Feb 2015
Anson Cheung (University of British Columbia, St. Paul’s Hospital, Vancouver, Canada) speaks to Cardiovascular News about the potential benefits of transcatheter mitral valve implantation. Exploring new transcatheter options for the mitral valve

Tailoring dual antiplatelet therapy duration for an individual patient
Tuesday, 03 Feb 2015
Guillaume Cayla explores how the duration of DAPT may be tailored after careful evaluation of both bleeding and ischaemic risk, taking into consideration the type of the device implanted. Tailoring dual antiplatelet therapy duration for an individual patient

Profiles


Sunil Rao
Thursday, 23 Oct 2014
Sunil Rao speaks to Cardiovascular News about his career highlights, including his research into ... Sunil Rao

Azeem Latib
Wednesday, 24 Sep 2014
Azeem Latib (senior interventional cardiologist, San Raffaele Hospital and EMO-GVM Centro Cuore C... Azeem Latib

Cardiac Rhythm News Vascular News Cardiovascular News Interventional News Spinal News NeuroNews
BIBA Medical BIBA MedTech Insights CX Symposium ilegx
 
Password Reminder

BIBA Medical, 526 Fulham Road, Fulham, London, SW6 5NR.
TEL: +44 (0)20 7736 8788 FAX: +44 (0)20 7736 8283 EMAIL: 
info@bibamedical.com
© BIBA Medical Ltd is a company registered in England and Wales with company number 2944429.
VAT registration number 730 6811 50.
Site Map | Terms and Conditions