Key result
In patients with chronic heart failure, hyperkalemia (> 5 mmol/L) occurred in 21.6% of patients and was independently associated with ACE-I/ARB use (OR 1.697), MRA use (OR 1.511), and lower eGFR.
Why the study?
Hyperkalemia is a common and potentially life-threatening complication in heart failure, prompting an evaluation of its frequency and associated factors using real-life outpatient data.
Observational (n=1,146)
No
In a real-world heart failure outpatient cohort, hyperkalemia (>5 mmol/L) occurred in 21.6% of patients and was independently associated with lower eGFR and the use of ACE-I/ARB and MRAs.
Hyperkalemia risk warrants monitoring in HF outpatients on ACE-I/ARB or MRAs; leaves open whether targeted interventions improve outcomes.
Aim: Hyperkalemia is a common and potentially life-threatening problem in heart failure (HF). In this study, we aimed to show the frequency of hyperkalemia and related factors in the HF outpatient clinic with real-life data.Methods: 1 146 patients monitored in the HF outpatient clinic with left ventricular ejection fraction ≤ 40% and potassium level ≥ 3.5 mmol/L were included.Results: The potassium value of the patients was median 4.6 mmol/L [IQR, 4.3-5]. It was evaluated in three groups as 3.5-5 mmol/L (normokalemia), 5.1-5.5 mmol/L (mild hyperkalemia) and ≥ 5.5 mmol/L (moderate to severe hyperkalemia), according to baseline potassium levels. Mild hyperkalemia was present in 14.5% and moderate to severe hyperkalemia was present in 7.1%. The potassium value was > 5 mmol/L in 21.6% of the patients. The estimated glomerular filtration rate (eGFR) (OR: 0.969, 95% CI: 0.961-0.976, p<0.001), angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACE-I/ARB) (OR: 1.697, 95% CI: 1.124-2.562, p=0.012), and mineralocorticoid receptor antagonists (MRA) (OR: 1.511, 95% CI: 1.066-2.142, p=0.02) were considered as independent factors for hyperkalemia.Conclusion: eGFR level, ACE-I/ARB, and MRA were associated with hyperkalemia in chronic HF in real-life data.
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Öztekin et al. (2022) conducted an observational in Heart failure (n=1,146). ACE-I/ARB use vs. No ACE-I/ARB use was evaluated on Hyperkalemia (potassium > 5 mmol/L) (OR 1.697, 95% CI 1.124-2.562, p=0.012). In patients with chronic heart failure, hyperkalemia (> 5 mmol/L) occurred in 21.6% of patients and was independently associated with ACE-I/ARB use (OR 1.697), MRA use (OR 1.511), and lower eGFR.
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