The prognostic role of moderate hyperkalemia in reduced ejection fraction (HFrEF) patients is still controversial. Despite this, it affects the use of renin-angiotensin-aldosterone system inhibitors (RAASi) with therapy down-titration or discontinuation.
Background: The prognostic role of moderate hyperkalemia in reduced ejection fraction (HFrEF) patients is still controversial. Despite this, it affects the use of renin–angiotensin–aldosterone system inhibitors (RAASi) with therapy down-titration or discontinuation. Objectives: Aim of the study was to assess the prognostic impact of moderate hyperkalemia in chronic HFrEF optimally treated patients. Methods and results: We retrospectively analyzed MECKI (Metabolic Exercise test data combined with Cardiac and Kidney Indexes) database, with median follow-up of 4.2 [IQR 1.9–7.5] years. Data on K+ levels were available in 7087 cases. Patients with K+ plasma level ≥ 5.6 mEq/L and < 4 mEq/L were excluded. Remaining patients were categorized into normal >4 and < 5 mEq/L (n = 4826, 68%) and moderately high ≥5.0 and ≤ 5.5 mEq/L (n = 496, 7%) K+. Then patients were matched by propensity score in 484 couplets of patients. MECKI score value was 7% [IQR 3.1–14.1%] and 7.3% [IQR 3.4–15%] (p = 0.678) in patients with normal and moderately high K+ values while cardiovascular mortality events at two years follow-up were 41 (4.2%) and 33 (3.4%) (p = 0.333) in each group respectively. Conclusions: Moderate hyperkalemia does not influence patients' outcome in a large cohort of ambulatory HFrEF patients.
Does moderate hyperkalemia influence survival in HF? Insights from the MECKI score data base / Toto, Federica; Salvioni, Elisabetta; Magrì, Damiano; Sciomer, Susanna; Piepoli, Massimo; Badagliacca, Roberto; Galotta, Arianna; Baracchini, Nikita; Paolillo, Stefania; Corrà, Ugo; Raimondo, Rosa; Lagioia, Rocco; Filardi, Pasquale Perrone; Iorio, Annamaria; Senni, Michele; Correale, Michele; Cicoira, Mariantonietta; Perna, Enrico; Metra, Marco; Guazzi, Marco; Limongelli, Giuseppe; Sinagra, Gianfranco; Parati, Gianfranco; Cattadori, Gaia; Bandera, Francesco; Bussotti, Maurizio; Mapelli, Massimo; Cipriani, Manlio; Bonomi, Alice; Cunha, Gonçalo; Vignati, Carlo; Garascia, Andrea; Lombardi, Carlo; Scardovi, Angela B; Passantino, Andrea; Emdin, Michele; Passino, Claudio; Santolamazza, Caterina; Girola, Davide; Zaffalon, Denise; Vizza, Dario; De Martino, Fabiana; Agostoni, Piergiuseppe; Re, Federica. - In: INTERNATIONAL JOURNAL OF CARDIOLOGY. - ISSN 0167-5273. - 371:(2023), pp. 273-277. [10.1016/j.ijcard.2022.09.030]
Does moderate hyperkalemia influence survival in HF? Insights from the MECKI score data base
Metra, Marco;
2023-01-01
Abstract
Background: The prognostic role of moderate hyperkalemia in reduced ejection fraction (HFrEF) patients is still controversial. Despite this, it affects the use of renin–angiotensin–aldosterone system inhibitors (RAASi) with therapy down-titration or discontinuation. Objectives: Aim of the study was to assess the prognostic impact of moderate hyperkalemia in chronic HFrEF optimally treated patients. Methods and results: We retrospectively analyzed MECKI (Metabolic Exercise test data combined with Cardiac and Kidney Indexes) database, with median follow-up of 4.2 [IQR 1.9–7.5] years. Data on K+ levels were available in 7087 cases. Patients with K+ plasma level ≥ 5.6 mEq/L and < 4 mEq/L were excluded. Remaining patients were categorized into normal >4 and < 5 mEq/L (n = 4826, 68%) and moderately high ≥5.0 and ≤ 5.5 mEq/L (n = 496, 7%) K+. Then patients were matched by propensity score in 484 couplets of patients. MECKI score value was 7% [IQR 3.1–14.1%] and 7.3% [IQR 3.4–15%] (p = 0.678) in patients with normal and moderately high K+ values while cardiovascular mortality events at two years follow-up were 41 (4.2%) and 33 (3.4%) (p = 0.333) in each group respectively. Conclusions: Moderate hyperkalemia does not influence patients' outcome in a large cohort of ambulatory HFrEF patients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
