Potassium and the use of renin-angiotensin-aldosterone system inhibitors in heart failure with reduced ejection fraction: data from BIOSTAT-CHF
Autor: | Marco Metra, Stefan D. Anker, Kenneth Dickstein, Faiez Zannad, Patrick Rossignol, Piotr Ponikowski, Dirk J. van Veldhuisen, Adriaan A. Voors, Haye H. van der Wal, Leong L. Ng, Peter van der Meer, Chim C. Lang, Gerasimos Filippatos, Joost C. Beusekamp, Pim van der Harst, Jasper Tromp, Hans L. Hillege, John G.F. Cleland, Aeilko H. Zwinderman, Nilesh J. Samani |
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Rok vydání: | 2018 |
Předmět: |
medicine.medical_specialty
Ejection fraction Dose business.industry Potassium chemistry.chemical_element 030204 cardiovascular system & hematology medicine.disease 3. Good health 03 medical and health sciences 0302 clinical medicine chemistry Serum potassium Interquartile range Internal medicine Heart failure Renin–angiotensin system medicine Cardiology In patient cardiovascular diseases 030212 general & internal medicine Cardiology and Cardiovascular Medicine business |
Zdroj: | European Journal of Heart Failure. 20:923-930 |
ISSN: | 1388-9842 |
Popis: | Background: Hyperkalaemia is a common co-morbidity in patients with heart failure with reduced ejection fraction (HFrEF). Whether it affects the use of renin–angiotensin–aldosterone system inhibitors and thereby negatively impacts outcome is unknown. Therefore, we investigated the association between potassium and uptitration of angiotensin-converting enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARB) and its association with outcome. Methods and results: Out of 2516 patients from the BIOSTAT-CHF study, potassium levels were available in 1666 patients with HFrEF. These patients were sub-optimally treated with ACEi/ARB or beta-blockers and were anticipated and encouraged to be uptitrated. Potassium levels were available at inclusion and at 9 months. Outcome was a composite of all-cause mortality and heart failure hospitalization at 2 years. Patients' mean age was 67 ± 12 years and 77% were male. At baseline, median serum potassium was 4.3 (interquartile range 3.9–4.6) mEq/L. After 9 months, 401 (24.1%) patients were successfully uptitrated with ACEi/ARB. During this period, mean serum potassium increased by 0.16 ± 0.66 mEq/L (P 0.5 for all). Conclusion: Higher potassium levels are an independent predictor of enduring lower dosages of ACEi/ARB. Higher potassium levels do not attenuate the beneficial effects of ACEi/ARB uptitration. |
Databáze: | OpenAIRE |
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