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, F.; Salvioni, E.; Magri, D.; Sciomer, S.; Piepoli, M.; Badagliacca, R.; Galotta, A.; Baracchini, N.; Paolillo, S.; Corra, U.; Raimondo, R.; Lagioia, R.; Filardi, P. P.; Iorio, A.; Senni, M.; Correale, M.; Cicoira, M.; Perna, E.; Metra, M.; Guazzi, M.; Limongelli, G.; Sinagra, G.; Parati, G.; Cattadori, G.; Bandera, F.; Bussotti, M.; Mapelli, M.; Cipriani, M.; Bonomi, A.; Cunha, G.; Re, F.; Vignati, C.; Garascia, A.; Lombardi, C.; Scardovi, A. B.; Passantino, A.; Emdin, M.; Passino, C.; Santolamazza, C.; Girola, D.; Zaffalon, D.; Vizza, D.; De Martino, F.; Agostoni, P.. - 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
Piepoli M.;Paolillo S.;Filardi P. P.;Limongelli G.;Passantino A.;
2023
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.
