Open AccessPrognostic significance of serum potassium in patients hospitalized for acute heart failure
Author(s) -
Lombardi Carlo Mario,
Carubelli Valentina,
Peveri Giulia,
Inciardi Riccardo Maria,
Pagnesi Matteo,
Ravera Alice,
Tomasoni Daniela,
Garafa Emirena,
Oriecuia Chiara,
Specchia Claudia,
Metra Marco
Publication year - 2022
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.13925
Subject(s) - medicine , heart failure , hyperkalemia , clinical endpoint , ejection fraction , cardiology , hypokalemia , retrospective cohort study , renal function , clinical trial
Aim We investigated the prognostic significance of serum potassium abnormalities at discharge in patients hospitalized for acute heart failure (AHF). Methods and results In a retrospective analysis, we included 926 patients hospitalized for AHF, stratified by serum potassium levels at discharge as hypokalaemia (<3.5 mEq/L), normokalaemia (3.5–5.0 mEq/L), and hyperkalaemia (>5.0 mEq/L). The primary endpoint was all‐cause death at 1 year since hospital discharge. At discharge, 40 patients had hypokalaemia (4.3%), 840 normokalaemia (90.7%), and 46 hyperkalaemia (5.0%). Patients with hyperkalaemia at discharge were more frequently men, had more signs of congestion, and lower LVEF while patients with hypokalaemia were more likely to be women with HFpEF. Treatment with ACEi/ARBs and MRAs ≥50% of target dose at discharge was similar across groups. One year all‐cause death occurred in 10% of the patients with hypokalaemia, 13.9% of those with normokalaemia, and 30.4% of those with hyperkalaemia ( P = 0.006). After adjustment for covariates, including renal function, background treatment, and baseline potassium level, hyperkalaemia resulted an independent predictor of the primary endpoint (HR 1.96, 95% IC [1.01–3.82]; P = 0.048). Conclusions In patients with AHF, the presence of hyperkalaemia at discharge is an independent predictor of 1 year all‐cause death.