In the wake of the latest clinical guidelines - mineralocorticoid receptor antagonists in the treatment of chronic heart failure

Chronic heart failure (CHF) today is a heart condition with the least favourable prognosis. Over the past 10-15 years, in addition to strong rationale supporting the effectiveness of angiotensin-converting enzyme inhibitors (ACEI), results of use were obtained for angiotensin receptor blockers (ARB) and beta-blockers (BB), as well as new pharmacotherapies, such as mineralocorticoid receptor antagonists (MCRA), sinoatrial node activity inhibitors, and non-pharmacological interventions - implantable cardioverter-defibrillators and cardiac resynchronization therapy. The recent clinical guidelines for diagnosis and treatment of heart failure provide different classes of recommendation and levels of evidence for the mentioned approaches. One of the most significant changes in CHF pharmacotherapy is supplementation of ACEI and BB with MCRA as the primary treatment for patients with systolic heart failure (class I recommendation, A level of evidence). In this article, we would like to focus on the key aspects of using MCRA in patients with CHF.