Serum potassium levels <3.5 mmol/L (HR 2.05) and >5.0 mmol/L (HR 1.84) were associated with increased 90-day mortality risk in AF patients co-treated with diuretics and rate/rhythm-control drugs.
Cohort (n=14,425)
Are abnormal serum potassium levels associated with increased 90-day mortality in AF patients co-treated with diuretics and rate- or rhythm-controlling drugs?
In AF patients treated with diuretics and rate- or rhythm-controlling drugs, both low and high normal range potassium levels, as well as hypo- and hyperkalemia, are associated with increased 90-day mortality.
Effect estimate: HR 2.05 (95% CI 1.68-2.50)
AIMS: We investigated the association between potassium levels and 90-day all-cause mortality in atrial fibrillation or flutter (AF) patients co-treated with diuretics and rate- or rhythm-controlling drugs. METHODS AND RESULTS: During 2000-12, first-time AF patients treated with beta-blockers, amiodarone, sotalol, verapamil, or digoxin combined with any diuretic within 90 days post-AF discharge were included. Following co-treatment, a potassium measurement within 90 days after initiating diuretic treatment was required. Mortality risk associated with potassium 5.0 mmol/L (reference: 4.1-4.4 mmol/L) was assessed using multivariable Cox regression. In total, 14 425 AF patients were included (median age: 78 years; women: 52%). Patients most often received beta-blocker monotherapy (29%), beta-blockers and digoxin combined (25%), digoxin monotherapy (24%), amiodarone monotherapy (3%), and verapamil monotherapy (3%). Increased 90-day mortality risk was associated with 5.0 mmol/L: (HR 1.84, 95% CI 1.53-2.21). Compared with beta-blocker monotherapy, rate- or rhythm-controlling drugs did not modify the association between potassium groups and mortality risk. CONCLUSION: In addition to hypo- and hyperkalaemia, low and high normal range potassium levels were associated with increased 90-day mortality risk in AF patients co-treated with diuretics and rate- or rhythm-controlling drugs. These associations were independent of rate- or rhythm-controlling drugs.
Hagengaard et al. (Fri,) conducted a cohort in Atrial fibrillation or flutter (n=14,425). Abnormal serum potassium levels (<3.5 to >5.0 mmol/L) vs. Serum potassium 4.1-4.4 mmol/L was evaluated on 90-day all-cause mortality (HR 2.05, 95% CI 1.68-2.50). Serum potassium levels <3.5 mmol/L (HR 2.05) and >5.0 mmol/L (HR 1.84) were associated with increased 90-day mortality risk in AF patients co-treated with diuretics and rate/rhythm-control drugs.