Association between hypo- and hyperkalemia and outcome in acute
heart failure patients: the role of medications

J 2018

Association between hypo- and hyperkalemia and outcome in acute heart failure patients: the role of medications

LEGRAND, M., P.O. LUDES, Z. MASSY, P. ROSSIGNOL, Jiří PAŘENICA et. al.

Basic information

Original name

Association between hypo- and hyperkalemia and outcome in acute heart failure patients: the role of medications

Authors

LEGRAND, M. (250 France, guarantor), P.O. LUDES (250 France), Z. MASSY (250 France), P. ROSSIGNOL (250 France), Jiří PAŘENICA (203 Czech Republic, belonging to the institution), J.J. PARK (410 Republic of Korea), S. ISHIHARA (392 Japan), K.F. ALHABIB (682 Saudi Arabia), A. MAGGIONI (380 Italy), O. MIRO (724 Spain), N. SATO (392 Japan), A. COHEN-SOLAL (250 France), E. FAIRMAN (32 Argentina), J. LASSUS (246 Finland), V.P. HARJOLA (246 Finland), C. MUELLER (756 Switzerland), F. PEACOCK (840 United States of America), D.J. CHOI (410 Republic of Korea), P. PLAISANCE (250 France), Jindřich ŠPINAR (203 Czech Republic, belonging to the institution), M. KOSIBOROD (840 United States of America), A. MEBAZAA (250 France) and E. GAYAT (250 France)

Edition

Clinical Research in Cardiology, Heidelberg, Springer, 2018, 1861-0684

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

Germany

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 4.907

RIV identification code

RIV/00216224:14110/18:00103657

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1007/s00392-017-1173-3

UT WoS

000425730100003

Keywords in English

Mortality; Potassium; B-blockers; Heart failure; Renal failure

Abstract

V originále

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.

Citovat

LEGRAND, M., P.O. LUDES, Z. MASSY, P. ROSSIGNOL, Jiří PAŘENICA, J.J. PARK, S. ISHIHARA, K.F. ALHABIB, A. MAGGIONI, O. MIRO, N. SATO, A. COHEN-SOLAL, E. FAIRMAN, J. LASSUS, V.P. HARJOLA, C. MUELLER, F. PEACOCK, D.J. CHOI, P. PLAISANCE, Jindřich ŠPINAR, M. KOSIBOROD, A. MEBAZAA and E. GAYAT. Association between hypo- and hyperkalemia and outcome in acute heart failure patients: the role of medications. Clinical Research in Cardiology. Heidelberg: Springer, 2018, vol. 107, No 3, p. 214-221. ISSN 1861-0684. Available from: https://dx.doi.org/10.1007/s00392-017-1173-3.

@article{1435289,
   author = {Legrand, M. and Ludes, P.O. and Massy, Z. and Rossignol, P. and Pařenica, Jiří and Park, J.J. and Ishihara, S. and AlHabib, K.F. and Maggioni, A. and Miro, O. and Sato, N. and CohenandSolal, A. and Fairman, E. and Lassus, J. and Harjola, V.P. and Mueller, C. and Peacock, F. and Choi, D.J. and Plaisance, P. and Špinar, Jindřich and Kosiborod, M. and Mebazaa, A. and Gayat, E.},
   article_location = {Heidelberg},
   article_number = {3},
   doi = {http://dx.doi.org/10.1007/s00392-017-1173-3},
   keywords = {Mortality; Potassium; B-blockers; Heart failure; Renal failure},
   language = {eng},
   issn = {1861-0684},
   journal = {Clinical Research in Cardiology},
   title = {Association between hypo- and hyperkalemia and outcome in acute heart failure patients: the role of medications},
   volume = {107},
   year = {2018}
}

TY  - JOUR
ID  - 1435289
AU  - Legrand, M. - Ludes, P.O. - Massy, Z. - Rossignol, P. - Pařenica, Jiří - Park, J.J. - Ishihara, S. - AlHabib, K.F. - Maggioni, A. - Miro, O. - Sato, N. - Cohen-Solal, A. - Fairman, E. - Lassus, J. - Harjola, V.P. - Mueller, C. - Peacock, F. - Choi, D.J. - Plaisance, P. - Špinar, Jindřich - Kosiborod, M. - Mebazaa, A. - Gayat, E.
PY  - 2018
TI  - Association between hypo- and hyperkalemia and outcome in acute heart failure patients: the role of medications
JF  - Clinical Research in Cardiology
VL  - 107
IS  - 3
SP  - 214-221
EP  - 214-221
PB  - Springer
SN  - 18610684
KW  - Mortality
KW  - Potassium
KW  - B-blockers
KW  - Heart failure
KW  - Renal failure
N2  - 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.
ER  -

LEGRAND, M., P.O. LUDES, Z. MASSY, P. ROSSIGNOL, Jiří PAŘENICA, J.J. PARK, S. ISHIHARA, K.F. ALHABIB, A. MAGGIONI, O. MIRO, N. SATO, A. COHEN-SOLAL, E. FAIRMAN, J. LASSUS, V.P. HARJOLA, C. MUELLER, F. PEACOCK, D.J. CHOI, P. PLAISANCE, Jindřich ŠPINAR, M. KOSIBOROD, A. MEBAZAA and E. GAYAT. Association between hypo- and hyperkalemia and outcome in acute heart failure patients: the role of medications. \textit{Clinical Research in Cardiology}. Heidelberg: Springer, 2018, vol.~107, No~3, p.~214-221. ISSN~1861-0684. Available from: https://dx.doi.org/10.1007/s00392-017-1173-3.

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