The major trials of ARAs in heart failure to date have been the Randomized Aldactone Evaluation Study (RALES), the Eplerenone Post-acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS), and the Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure (EMPHASIS-HF).
Close monitoring is essential when starting an ARA, as severe hyperkalemia and renal insufficiency can occur.