Influence of aldosterone antagonists on markers of electrophysiological instability in patients with heart failure with mid-range ejection fraction after ST-segment elevation acute coronary syndrome in the short- and long-term periods

Aim. To compare the effect of long-term therapy with mineralocorticoid receptor antagonists (MCRA) on markers of electrophysiological instability in patients with heart failure with mid-range ejection fraction (HFmrEF) after ST-segment elevation acute coronary syndrome (STE-ACS) with revascularization.Material and methods. We examined 60 patients with HFmrEF (LVEF=40-49%), who underwent STE-ACS with revascularization by percutaneous coronary intervention (PCI). Depending on the MCRA agent taken, the patients were divided into 2 groups: group 1 — eplerenone, group 2 — spironolactone. Electrocardiography (ECG) was carried out on the 1st, 30th days and 12 months after PCI.Results. Adjusted dispersion indices of the QT interval and its parts (QTcd, JTcd, QTapcd, SubTcd) were determined as markers of sudden cardiac death. In the acute period of the disease, they significantly exceeded the values of the control group: QTcd by 174,8% (p