Short-term prognosis of changes in plasma potassium following an episode of hyperkalaemia in patients with chronic heart failure.

Autor: Jønsson SS; Department of Health, Science, and Technology, Aalborg University, Aalborg, Denmark; Centre for Clinical Research, North Denmark Regional Hospital, Hjoerring, Denmark. Electronic address: s.joensson@rn.dk., Sørensen SA; Department of Health, Science, and Technology, Aalborg University, Aalborg, Denmark; Centre for Clinical Research, North Denmark Regional Hospital, Hjoerring, Denmark., Krøgh ST; Department of Health, Science, and Technology, Aalborg University, Aalborg, Denmark; Centre for Clinical Research, North Denmark Regional Hospital, Hjoerring, Denmark., Melgaard D; North Denmark Regional Hospital, Hjoerring, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark., Søgaard P; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark., Søndergaard MM; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark., Leutscher P; Centre for Clinical Research, North Denmark Regional Hospital, Hjoerring, Denmark; North Denmark Regional Hospital, Hjoerring, Denmark., Kragholm K; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark., Aldahl M; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark., Torp-Pedersen C; Department of Cardiology, Nordsjaellands Hospital, Hillerød, Denmark; Department of Public Health, University of Copenhagen, Denmark., Krogager ML; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
Jazyk: angličtina
Zdroj: European journal of internal medicine [Eur J Intern Med] 2023 Dec; Vol. 118, pp. 82-88. Date of Electronic Publication: 2023 Jul 28.
DOI: 10.1016/j.ejim.2023.07.031
Abstrakt: Background/aim: There is an increasing prevalence of chronic heart failure (HF). It is well known that patients with HF and disturbances in the potassium level have an increased mortality risk. The aim of this study was to investigate the prognosis of a second plasma-potassium measurement after an episode with hyperkalaemia on short-term mortality in patients with chronic HF.
Methods and Results: From Danish national registers, 2,339 patients with chronic HF and hyperkalaemia (>4.6 mmol/L) at first potassium measurement within 14-365 days from concomitant treatment were identified. To be included, a second measurement was required within 6-30 days subsequent to the first measurement and the 60-day mortality was observed. Based on the second measurement, the patients were divided into five groups: <3.5 mmol/L (n = 257), 3.5-4.0 mmol/L (n = 709), 4.1-4.6 mmol/L (n = 1,204, reference), 4.7-5.0 mmol/L (n = 89) and >5.0 mmol/L (n = 80). To assess all-cause and cardiovascular mortality, we used the Cox regression model. The multivariable analysis showed that patients with potassium concentrations <3.5 mmol/L (hazard ratio (HR): 3.03; 95% CI: 2.49-3.70) and 3.5-4.0 mmol/L (HR: 1.81; 95% CI: 1.54-2.14) had a worse prognosis compared to the reference. We observed similar results when calculating the risk of cardiovascular mortality. A restricted cubic spline curve showed a U-shaped relationship between plasma-potassium and all-cause mortality.
Conclusion: Patients with chronic HF and hyperkalaemia who became hypokalaemic after 6-30 days were associated with a higher 60-day all-cause and cardiovascular mortality compared to the reference. This also applied for patients with low normal potassium concentrations (3.5-4.0 mmol/L).
(Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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