Article
Use of aldosterone antagonists at the University hospital Jena
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Authors
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Katrin Farker
- Universitätsklinikum Jena, Apotheke, Universitäres Zentrum für Pharmakotherapie und Pharmakoökonomie (UZP), Jena, Germany
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Julia Weber
- Universitätsklinikum Jena, Apotheke, Universitäres Zentrum für Pharmakotherapie und Pharmakoökonomie (UZP), Jena, Germany
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Benjamin Wende
- Universitätsklinikum Jena, Apotheke, Universitäres Zentrum für Pharmakotherapie und Pharmakoökonomie (UZP), Jena, Germany
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Michael Hartmann
- Universitätsklinikum Jena, Apotheke, Jena, Germany
| Published: | December 5, 2017 |
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Outline
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Background: In 2012, a new guideline for the treatment of heart failure of the European society of cardiology was published. According to the EMPHASIS-HF-trial, mineralocorticoid receptor antagonists are indicated in all stages of symptomatic chronic heart failure under treatment with -blockers and ACE-inhibitors. We wanted to know, if and how the guideline was implemented at the University Hospital Jena after 2012. Therefore we analysed the use of aldosterone antagonists at the University hospital Jena in the last 5 years.
Materials and Methods: A retrospective analysis of the use of aldosterone antagonists was performed using drug data from all clinics at the University hospital Jena between 2012 and 2016.
Results: A General trend in aldosterone antagonist use could be shown. The aldosterone antagonist use increased during the last years at the University hospital Jena. Especially in clinics where patients with cardiological diseases are treated like Clinic for Internal Medicine, Department of Cardiology and Intensive Care Medicine, Department of Cardiothoracic Surgery or Department of Anesthesiology and Intensive Care Medicine we observed an increase of use of this class of drugs. Interestingly the aldosterone antagonist use peaked in 2013. Spironolactone as well as eplerenone use increased, whereas no changes in the very low use of potassium canrenoate was observed. In particular increased the use of the selective mineralocorticoid receptor antagonist eplerenone steadily from 2012 to 2016. We suppose as reason therefore that eplerenone which is associated with lower rates of adverse effects like impotence, gynecomastia or breast pain in comparison to spironolactone.
Conclusion: The increase of use of aldosterone antagonists shows the short implementation time of guidelines for drug use at the University hospital Jena. Our data indicate the compliance with the heart failure guideline from 2012 particularly in cardiological departments, where aldosterone antagonists therapy in patients with advanced heart failure and reduced ejection fraction is widely recommended as it decreases mortality and hospitalisation.
