Serum Aldosterone as Predictor of Progression of Coronary Heart Disease in Patients Without Signs of Heart Failure After Acute Myocardial Infarction

Abstract

Introduction: In patients with acute myocardial infarction (AMI) early risk assessment of development of complications is of great importance. It is proven that aldosterone level has a major role in progression of cardiovascular pathology. Aim: Determination of influence of aldosterone plasma level in the progression of heart disease in patients without signs of heart failure after AMI. Material and Methods: Research included 207 patients, hospitalized in the acute phase of myocardial infarction, and who were divided into two groups: 127 patients with no clinical signs of heart failure and 60 patients with heart failure. Results: The serum aldosterone concentration was 73.4% higher in the group of decompensated patients, 128 pg/mL (75.4-236 pg/mL) in decompensated and 73.7 pg/mL (42.7 -115.25 pg/mL) in compensated. In the group of compensated patients, changes in aldosterone levels showed a statistically significant effect on the incidence of post-infarction angina (p=0.0001) as well as reinfarction (p=0.009). There is a connection between changes in aldosterone plasma level and positive stress test (p=0.012). Conclusion: In patients with AMI, elevated serum aldosterone level can be prognostic factor of the progression of coronary heart disease, development of heart failure, as well of development of post-infarction angina, myocardial reinfarction and pathological finding on the stress test.

Nonsteroidal Mineralocorticoid Receptor Antagonists: Exploring Role in Cardiovascular Disease

“…25 In patients with ischemic heart disease, elevated aldosterone concentrations have been correlated with development of HF, anginal symptoms, worsening coronary artery disease, and reinfarction. 26 Although elevated aldosterone levels have been associated with worse outcomes, not all patients with HF and ischemic heart disease have elevated aldosterone plasma levels. For example, in a subset of patients enrolled in the Randomized Aldactone Evaluation Study (RALES) in whom neurohormonal data were collected, the geometric mean [95% confidence interval (CI)] baseline aldosterone plasma concentration was 0.37 nmol/ mL (0.31-0.45) in the place group and 0.32 nmol/mL (0.25-0.41) in the spironolactone group, P = 0.40.…”