medicina58巻1号

2021年01月発行

特集 エキスパートに学ぶ—最新の循環器治療薬の使い方 循環器common diseaseの治療を再考する

—心不全治療薬・4—ミネラルコルチコイド受容体拮抗薬（MRA）

著者： 夜久英憲¹

所属機関： ¹三菱京都病院心臓内科

ページ範囲：P.90 - P.94

Question 1
HFrEFではミネラルコルチコイド受容体拮抗薬（MRA）は全例に必要でしょうか？ また用量設定は必要ですか？

参考文献

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17）Study to evaluate the efficacy（effect on disease）and safety of finerenone on morbidity（events indicating disease worsening）and mortality（death rate）in participants with heart failure and left ventricular ejection fraction（proportion of blood expelled per heart stroke）greater or equal to 40%（FINEARTS-HF).　https://www.clinicaltrials.gov/ct2/show/NCT04435626（2020年10月閲覧）

18）Vardeny O, et al：Influence of age on efficacy and safety of spironolactone in heart failure. JACC Hear Fail 7：1022-1028, 2019

19）Hernandez AF, et al：Associations between aldosterone antagonist therapy and risks of mortality and readmission among patients with heart failure and reduced ejection fraction. JAMA 308：2097-2107, 2012

20）Yaku H, et al：Association of mineralocorticoid receptor antagonist use with all-cause mortality and hospital readmission in older adults with acute decompensated heart failure. JAMA Netw Open 2：e195892, 2019