Статья
Новые клинические аспекты применения эплеренона в клинической практике
Обсуждается проблема недостаточно высокой частоты применения эплеренона в клинической практике у больных, имеющих очевидные показания к данной терапии.В статье рассматривается проблема несоответствия между убедительными доказательствами эффективности применения антагонистов минералокортикоидных рецепторов у больных с сердечной недостаточностью и сниженной фракцией выброса левого желудочка и недостаточно частым их использовании в клинической практике при лечении таких больных, а также приводятся мнения экспертов о причинах такого несоответствия. Обсуждаются новые данные об эффективности применения антагониста минералокортикоидных рецепторов эплеренона в определенных клинических ситуациях, которые, в основном, были получены в ходе выполнения анализа в подгруппах участников крупного рандомизированного клинического исследования EMPHASIS-HF по оценке эффективности применения эплеренона по сравнению с плацебо у больных с сердечной недостаточностью и сниженной функцией левого желудочка. Кроме того, приводятся данные экспериментальных исследований на животных, которые могут указывать на плейотропные эффекты эплеренона у больных с сосудистыми заболеваниями. Приводимые в статье новые данные об эффективности применения эплеренона в подгруппах больных сердечной недостаточностью и определенными характеристиками могут стать дополнительным основанием для привлечения внимания врачей к преимуществам его использования и, соответственно, более частого его назначения в клинической практике при лечении больных, имеющих очевидные показания к данной терапии.
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