Abstract

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.

Details

Title
Prognostic significance of serum potassium in patients hospitalized for acute heart failure
Author
Lombardi, Carlo Mario 1   VIAFID ORCID Logo  ; Carubelli, Valentina 1   VIAFID ORCID Logo  ; Peveri, Giulia 2 ; Inciardi, Riccardo Maria 1 ; Pagnesi, Matteo 1 ; Ravera, Alice 1 ; Tomasoni, Daniela 1 ; Garafa, Emirena 3 ; Oriecuia, Chiara 4 ; Specchia, Claudia 5 ; Metra, Marco 1 

1  Department of Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University and Civil Hospital of Brescia, Brescia, Italy 
2  Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden 
3  Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy, Department of Laboratory Diagnostics, ASST Spedali Civili, Brescia, Italy 
4  Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy 
5  Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy 
Pages
2357-2366
Section
Original Articles
Publication year
2022
Publication date
Aug 1, 2022
Publisher
Oxford University Press
e-ISSN
20555822
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1002/ehf2.13925
ProQuest document ID
2690638342
Copyright
© 2022. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.