Effect of Renin Angiotensin Aldosterone System Genetic Polymorphism on the Pharmacological Effect of Mineralocorticoid Receptor Antagonists in Patients With Myocardial Infarction

Inclusion Criteria: * ST- segment elevation patients. * Patients who are candidate for add-on treatment with Mineralocorticoid receptor antagonists (MRAs) to improve cardiac remodeling. * Age of 18 years to 80 years. * Written informed consent of the subject to participate in the study. Exclusion Criteria: * Contraindications to Mineralocorticoid receptor antagonists (MRA) including: serum potassium \>5.5 mEq/L at initiation; CrCl ≤30 mL/minute; concomitant use of strong CYP3A4 inhibitors; concomitant use with potassium supplements or potassium-sparing diuretics. * Mild-to-severe valvular stenosis or severe (grade III/IV) valvular regurgitation * Pregnant or nursing women. * Non cardiac disorders associated with increased growth factor (e.g., HIV, Alzheimer, Crohn's disease, Cancer, glomerulonephritis, glomerulosclerosis, diabetic nephropathy, muscle atrophy, fibrotic conditions and burns). * Patients with chronic heart failure with reduced ejection fraction (LVEF \<40%).