{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:43:00Z","timestamp":1790419380890,"version":"4.1.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2009,10,29]],"date-time":"2009-10-29T00:00:00Z","timestamp":1256774400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To test the hypothesis that an earlier post-acute myocardial infarction (AMI) eplerenone initiation in patients with left ventricular systolic dysfunction (LVSD) and heart failure (HF) is associated with better long-term outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>The 6632 patients of the EPHESUS study were randomized from day 3 to 14 after the index AMI (median = 7 days), of these 3319 were assigned to eplerenone. We analysed the differential effects of time-to-eplerenone initiation vs. placebo, based on the median time to initiation of treatment (&amp;lt;7 days\u2014\u2018earlier\u2019, \u22657days\u2014\u2018later\u2019). Effects on outcomes were evaluated over a mean 16-month follow-up, using Cox proportional hazards regression analysis. The earlier eplerenone initiation (&amp;lt;7 days) reduced the risk of all-cause mortality by 31% (P = 0.001) when compared with the \u2018earlier\u2019 placebo\u2019 and also reduced the risks of cardiovascular (CV) hospitalization\/CV mortality by 24% (P &amp;lt; 0.0001) and sudden cardiac death (SCD) by 34% (P &amp;lt; 0.0001). In contrast, later eplerenone initiation (\u22657 days) had no significant effect on outcomes. Interactions between time-to-randomization and treatment were significant. These associations remained substantially unchanged after risk adjustment in multivariable models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An earlier eplerenone administration (3\u20137days) post-AMI improved outcomes in patients with LVSD and HF. This benefit was not observed when eplerenone was initiated later (\u22657days).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjhf\/hfp136","type":"journal-article","created":{"date-parts":[[2009,10,29]],"date-time":"2009-10-29T19:33:12Z","timestamp":1256844792000},"page":"1099-1105","source":"Crossref","is-referenced-by-count":86,"title":["Timing of Eplerenone Initiation and Outcomes in Patients with Heart Failure After Acute Myocardial Infarction Complicated by Left Ventricular Systolic Dysfunction: Insights from the EPHESUS Trial"],"prefix":"10.1093","volume":"11","author":[{"given":"Chris","family":"Adamopoulos","sequence":"first","affiliation":[{"name":"Inserm, Centre d\u2019Investigations Cliniques CIC Inserm CHU and U961, H\u00f4pital Jeanne d\u2019 Arc , Toul, 54200 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Ahmed","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham and VA Medical Center , Birmingham, AL ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renaud","family":"Fay","sequence":"additional","affiliation":[{"name":"Inserm, Centre d\u2019Investigations Cliniques CIC Inserm CHU and U961, H\u00f4pital Jeanne d\u2019 Arc , Toul, 54200 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Angioi","sequence":"additional","affiliation":[{"name":"Inserm, Centre d\u2019Investigations Cliniques CIC Inserm CHU and U961, H\u00f4pital Jeanne d\u2019 Arc , Toul, 54200 ,","place":["France"]},{"name":"Hypertension and Heart Failure Division, Department of Cardiovascular Disease, H\u00f4pital Jeanne d\u2019 Arc , Nancy ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Athens University Hospital Attikon , Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Vincent","sequence":"additional","affiliation":[{"name":"Pfizer Inc. , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertram","family":"Pitt","sequence":"additional","affiliation":[{"name":"University of Michigan , Ann Arbor, MI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faiez","family":"Zannad","sequence":"additional","affiliation":[{"name":"Inserm, Centre d\u2019Investigations Cliniques CIC Inserm CHU and U961, H\u00f4pital Jeanne d\u2019 Arc , Toul, 54200 ,","place":["France"]},{"name":"Hypertension and Heart Failure Division, Department of Cardiovascular Disease, H\u00f4pital Jeanne d\u2019 Arc , Nancy ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the EPHESUS 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