GREAT Global Res Acute Conditions , INI-CRCT Invest Network Initiative , Legrand , M , Lassus , J & Harjola , V-P 2018 , ' Association between hypo- and hyperkalemia and outcome in acute heart failure patients : the role of medications ' , Clinical Research in Cardiology , vol. 107 , no. 3 , pp. 214-221 . https://doi.org/10.1007/s00392-017-1173-3
Title: | Association between hypo- and hyperkalemia and outcome in acute heart failure patients : the role of medications |
Author: | GREAT Global Res Acute Conditions; INI-CRCT Invest Network Initiative; Legrand, Matthieu; Lassus, Johan; Harjola, Veli-Pekka |
Contributor organization: | HUS Heart and Lung Center Clinicum Kardiologian yksikkö Department of Medicine University of Helsinki HUS Emergency Medicine and Services |
Date: | 2018-03 |
Language: | eng |
Number of pages: | 8 |
Belongs to series: | Clinical Research in Cardiology |
ISSN: | 1861-0684 |
DOI: | https://doi.org/10.1007/s00392-017-1173-3 |
URI: | http://hdl.handle.net/10138/300885 |
Abstract: | Background The interaction between chronic medications on admission and the association between serum potassium level and outcome in patients with acute heart failure (AHF) are unknown. Methods Observational intercontinental study of patients admitted with AHF. 15954 patients were included from 12 cohorts in 4 continents. Main outcome was 90-day mortality. Clinical presentation (medication use, hemodynamics, comorbidities), demographic, echocardiographic, and biochemical data on admission were recorded prospectively in each cohort, with prospective adjudication of outcomes. Results Positive and negative linear relationships between 90-day mortality and sK+ above 4.5 mmol/L (hyperkalemia) and below 3.5 mmol/L (hypo-kalemia) were observed. Hazard ratio for death was 1.46 [1.34-1.58] for hyperkalemia and 1.22 [1.06-1.40] for hypokalemia. In a fully adjusted model, only hyperkalemia remained associated with mortality (HR 1.03 [1.02-1.04] for each 0.1 mmol/l change of sK+ above 4.5 mmol/L). Interaction tests revealed that the association between hyperkalemia and outcome was significantly affected by chronic medications. The association between hyperkalemia and mortality was absent for patients treated with beta blockers and in those with preserved renal function. Conclusions In patients with AHF, sK+ > 4.5 mmol/L appears to be associated with 90-day mortality. B-blockers have potentially a protective effect in the setting of hyperkalemia. |
Subject: |
Mortality
Potassium B-blockers Heart failure Renal failure REDUCED EJECTION FRACTION SERUM POTASSIUM LEVELS MORTALITY COHORT HOSPITALIZATION SPIRONOLACTONE ANTAGONISTS GUIDELINES HF 3121 General medicine, internal medicine and other clinical medicine |
Peer reviewed: | Yes |
Usage restriction: | openAccess |
Self-archived version: | publishedVersion |
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