Aldosterone-antagonists

• Add after RASi and bB if adeq. renal fxn and w/o hyperkalemia
• 25-30% ↓ mort. in NYHA II-IV & EF ≤35% (NEJM 2011;364:11)
• 15% ↓ mort. in HF post-MI, EF ≤40% (EPHESUS, NEJM 2003;348:1309)
• Watch for ↑ K.
• Do not use if GFR <30 or K ≥5