[Antialdosteronic therapy in mild chronic heart failure: from AREA IN-CHF to EMPHASIS-HF]

The clinical efficacy of aldosterone inhibition in heart failure was proved in two important clinical trials, RALES and EPHESUS, which demonstrated a reduction in mortality with aldosterone receptor blocker therapy in patients with severe and post-MI heart failure.The echocardiographic study AREA IN-CHF evaluated, for the first time, the effectiveness of aldosterone receptor blocker therapy in patients with mild to moderate heart failure (NYHA class II). The AREA IN-CHF rationale and results can be considered the pathophysiological background of the survival study EMPHASIS-HF conducted in a similar population of patients. On May 27, 2010 it was announced the earlier discontinuation of the recruitment to the EMPHASIS-HF that had an estimated end date around October 2011. Discontinuation is related to the excess of benefit in reducing risk of cardiovascular death or hospitalization for heart failure, obtained by antialdosteronic therapy.