Does moderate hyperkalemia influence survival in HF? Insights from the MECKI score data base.

Autor: Toto F; Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Cardiovascular and Respiratory Science, Sapienza University of Rome, Rome, Italy., Salvioni E; Centro Cardiologico Monzino, IRCCS, Milan, Italy., Magrì D; Department of Clinical and Molecular Medicine, Azienda Ospedaliera Sant'Andrea, 'Sapienza' Università degli Studi di Roma, Roma, Italy., Sciomer S; Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, 'Sapienza', Rome University, Rome, Italy., Piepoli M; UOC Cardiologia, G da Saliceto Hospital, Piacenza, Italy., Badagliacca R; Department of Cardiovascular and Respiratory Science, Sapienza University of Rome, Rome, Italy., Galotta A; Centro Cardiologico Monzino, IRCCS, Milan, Italy., Baracchini N; Cardiovascular Department, 'Azienda Sanitaria Universitaria Giuliano-Isontina', Trieste, Italy., Paolillo S; IRCCS SDN Istituto di Ricerca, Napoli, Italy., Corrà U; Cardiology Department, Istituti Clinici Scientifici Maugeri, IRCCS, Veruno Institute, Veruno, Italy., Raimondo R; Divisione di Cardiologia Riabilitativa, Istituti Clinici Scientifici Maugeri, Tradate, Italy., Lagioia R; UOC Cardiologia di Riabilitativa, Mater Dei Hospital, Bari, Italy., Filardi PP; Department of Advanced Biomedical Sciences, Federico II University of Naples and Mediterranea CardioCentro, Naples, Italy., Iorio A; Department of Cardiology, Heart Failure and Heart Transplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy., Senni M; Department of Cardiology, Heart Failure and Heart Transplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy., Correale M; Department of cardiology, University of Foggia, Foggia, Italy., Cicoira M; Poliambulatorio San Gaetano, Thiene., Perna E; Dipartimento Cardiologico 'A. De Gasperis', Ospedale Cà Granda- A.O. Niguarda, Milano, Italy., Metra M; Cardiology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Guazzi M; Ospedale San Paolo, Università degli studi di Milano, Italy., Limongelli G; Cardiologia SUN, Ospedale Monaldi (Azienda dei Colli), Seconda Università di Napoli, Napoli., Sinagra G; Cardiovascular Department, 'Azienda Sanitaria Universitaria Giuliano-Isontina', Trieste, Italy., Parati G; Istituto Auxologico Italiano, Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy., Cattadori G; Unità Operativa Cardiologia Riabilitativa, IRCCS Multimedica, Milano, Italy., Bandera F; Department of Biomedical Sciences for Health, University of Milano, Milan, Italy; Cardiology University Department, IRCCS Policlinico San Donato, Milan, Italy., Bussotti M; Cardiac Rehabilitation Unit, Istituti Clinici Scientifici Maugeri, Scientific Institute of Milan, Milan, Italy., Mapelli M; Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of clinical sciences and community health, Cardiovascular section, University of Milan, Milan, Italy., Cipriani M; ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy., Bonomi A; Centro Cardiologico Monzino, IRCCS, Milan, Italy., Cunha G; Centro Cardiologico Monzino, IRCCS, Milan, Italy; Cardiology department, Hospital de Santa Cruz, Carnaxide, Portugal., Re F; Cardiology Division, Cardiac Arrhythmia Center and Cardiomyopathies Unit, San Camillo-Forlanini Hospital, Roma, Italy., Vignati C; Centro Cardiologico Monzino, IRCCS, Milan, Italy., Garascia A; Dipartimento Cardiologico 'A. De Gasperis', Ospedale Cà Granda- A.O. Niguarda, Milano, Italy., Lombardi C; Cardiology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Scardovi AB; Cardiology Division, Santo Spirito Hospital, Roma, Italy., Passantino A; Division of Cardiology, Istituti Clinici Scientifici Maugeri, Institute of Bari, Bari, Italy., Emdin M; Institute of Life Science, Scuola Superiore Sant'Anna, Pisa, Italy; Fondazione Gabriele Monasterio, CNR-Regione Toscana, Pisa, Italy., Passino C; Institute of Life Science, Scuola Superiore Sant'Anna, Pisa, Italy., Santolamazza C; Dipartimento Cardiologico 'A. De Gasperis', Ospedale Cà Granda- A.O. Niguarda, Milano, Italy., Girola D; Clinica Hildebrand Centro di riabilitazione Brissago, Switzerland., Zaffalon D; Cardiovascular Department, 'Azienda Sanitaria Universitaria Giuliano-Isontina', Trieste, Italy., Vizza D; Department of Cardiovascular and Respiratory Science, Sapienza University of Rome, Rome, Italy., De Martino F; Centro Cardiologico Monzino, IRCCS, Milan, Italy., Agostoni P; Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of clinical sciences and community health, Cardiovascular section, University of Milan, Milan, Italy,. Electronic address: piergiuseppe.agostoni@unimi.it.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2023 Jan 15; Vol. 371, pp. 273-277. Date of Electronic Publication: 2022 Sep 15.
DOI: 10.1016/j.ijcard.2022.09.030
Abstrakt: 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.
Competing Interests: Declaration of Competing Interest None to declare.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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