Over the course of the study, the incidence of hyperkalemia (elevated potassium defined as serum potassium levels exceeding 5.5 mEq/L) occurred in 5.6% vs. 3.2% (p=0.09) in the eplerenone and placebo groups, respectively. Hypokalemia (serum potassium level below 3.5 mEq/L) occurred more frequently in the placebo group with 1.4% vs. 5.5% (p=0.0002) in the eplerenone and placebo groups, respectively. The rates of other adverse events were similar in both groups.
Commenting on the findings, the chair of the REMINDER Steering Committee Professor Gilles Montalescot, Institute of Cardiology, Centre Hospitalier Pitié-Salpêtriėre, Paris, France said: “Eplerenone improved the outcome of patients presenting with acute STEMI and without concomitant heart failure. This benefit was obtained in a low-risk population that was well treated, without serious adverse drug effect. Adding eplerenone to standard therapy as early as within the first 24 hours of symptoms reduced heart failure-related morbidity.”
About the REMINDER trial
The REMINDER trial was a randomized, double-blind trial, involving 1012 patients with acute STEMI without a history of HF or EF <40% and without signs of HF.The REMINDER trial was conducted in 11 countries: Canada, Czech Republic, France, Germany, Greece, Hungary, Netherlands, Poland, Slovakia, Spain, UK. The primary objective of the REMINDER trial was to assess the efficacy of Inspra 25 -50 mg once daily, compared to placebo, in the early treatment of acute ST-segment elevation myocardial infarction (STEMI) within 24 hours (preferably within the first 12h). The mean follow-up time was 10.5 months. The study was funded by Pfizer. About INSPRA ® INSPRA ® (eplerenone) is a steroid nucleus-based mineralcorticoid receptor (MR) antagonist with a higher degree of selectivity than spironolactone. Important Prescribing Information In the United States, Inspra® (eplerenone) is indicated to improve survival of stable patients with left ventricular (LV) systolic dysfunction (ejection fraction less than or equal to 40%) and clinical evidence of congestive heart failure (CHF) after an acute myocardial infarction (MI). Eplerenone is also indicated for the treatment of hypertension. Eplerenone may be used alone or in combination with other antihypertensive agents.