Does moderate hyperkalemia influence survival in HF? Insights from the MECKI score data base
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. Aim of the study was to assess the prognostic...
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| Veröffentlicht in: | International journal of cardiology 2023-01, Vol.371, p.273-277 |
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| creator | Toto, Federica Salvioni, Elisabetta Magrì, Damiano Sciomer, Susanna Piepoli, Massimo Badagliacca, Roberto Galotta, Arianna Baracchini, Nikita Paolillo, Stefania Corrà, Ugo Raimondo, Rosa Lagioia, Rocco Filardi, Pasquale Perrone Iorio, Annamaria Senni, Michele Correale, Michele Cicoira, Mariantonietta Perna, Enrico Metra, Marco Guazzi, Marco Limongelli, Giuseppe Sinagra, Gianfranco Parati, Gianfranco Cattadori, Gaia Bandera, Francesco Bussotti, Maurizio Mapelli, Massimo Cipriani, Manlio Bonomi, Alice Cunha, Gonçalo Re, Federica Vignati, Carlo Garascia, Andrea Lombardi, Carlo Scardovi, Angela B. Passantino, Andrea Emdin, Michele Passino, Claudio Santolamazza, Caterina Girola, Davide Zaffalon, Denise Vizza, Dario De Martino, Fabiana Agostoni, Piergiuseppe |
| description | 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.
Aim of the study was to assess the prognostic impact of moderate hyperkalemia in chronic HFrEF optimally treated patients.
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 and |
| doi_str_mv | 10.1016/j.ijcard.2022.09.030 |
| format | Article |
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Aim of the study was to assess the prognostic impact of moderate hyperkalemia in chronic HFrEF optimally treated patients.
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.
Moderate hyperkalemia does not influence patients' outcome in a large cohort of ambulatory HFrEF patients.
•Hyperkalemia affects up to 18% of HFrEF patients leading to therapy down-titration.•The prognostic role of moderate hyperkalemia is still controversial.•We discovered that moderate hyperkalemia in HF is not associated to worst outcome.</description><identifier>ISSN: 0167-5273</identifier><identifier>EISSN: 1874-1754</identifier><identifier>DOI: 10.1016/j.ijcard.2022.09.030</identifier><identifier>PMID: 36115445</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Heart Failure ; Humans ; Hyperkalemia ; Hyperkalemia - diagnosis ; Hyperkalemia - epidemiology ; Potassium ; Prognosis ; Renin angiotensin aldosterone system inhibitor ; Renin-Angiotensin System ; Retrospective Studies ; Stroke Volume</subject><ispartof>International journal of cardiology, 2023-01, Vol.371, p.273-277</ispartof><rights>2022 Elsevier B.V.</rights><rights>Copyright © 2022 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-b7f5ed88d2f5043cc4de1d8fe19a2792b389886f5b85bd4d30cb9091f8db48ad3</citedby><cites>FETCH-LOGICAL-c362t-b7f5ed88d2f5043cc4de1d8fe19a2792b389886f5b85bd4d30cb9091f8db48ad3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijcard.2022.09.030$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36115445$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Toto, Federica</creatorcontrib><creatorcontrib>Salvioni, Elisabetta</creatorcontrib><creatorcontrib>Magrì, Damiano</creatorcontrib><creatorcontrib>Sciomer, Susanna</creatorcontrib><creatorcontrib>Piepoli, Massimo</creatorcontrib><creatorcontrib>Badagliacca, Roberto</creatorcontrib><creatorcontrib>Galotta, Arianna</creatorcontrib><creatorcontrib>Baracchini, Nikita</creatorcontrib><creatorcontrib>Paolillo, Stefania</creatorcontrib><creatorcontrib>Corrà, Ugo</creatorcontrib><creatorcontrib>Raimondo, Rosa</creatorcontrib><creatorcontrib>Lagioia, Rocco</creatorcontrib><creatorcontrib>Filardi, Pasquale Perrone</creatorcontrib><creatorcontrib>Iorio, Annamaria</creatorcontrib><creatorcontrib>Senni, Michele</creatorcontrib><creatorcontrib>Correale, Michele</creatorcontrib><creatorcontrib>Cicoira, Mariantonietta</creatorcontrib><creatorcontrib>Perna, Enrico</creatorcontrib><creatorcontrib>Metra, Marco</creatorcontrib><creatorcontrib>Guazzi, Marco</creatorcontrib><creatorcontrib>Limongelli, Giuseppe</creatorcontrib><creatorcontrib>Sinagra, Gianfranco</creatorcontrib><creatorcontrib>Parati, Gianfranco</creatorcontrib><creatorcontrib>Cattadori, Gaia</creatorcontrib><creatorcontrib>Bandera, Francesco</creatorcontrib><creatorcontrib>Bussotti, Maurizio</creatorcontrib><creatorcontrib>Mapelli, Massimo</creatorcontrib><creatorcontrib>Cipriani, Manlio</creatorcontrib><creatorcontrib>Bonomi, Alice</creatorcontrib><creatorcontrib>Cunha, Gonçalo</creatorcontrib><creatorcontrib>Re, Federica</creatorcontrib><creatorcontrib>Vignati, Carlo</creatorcontrib><creatorcontrib>Garascia, Andrea</creatorcontrib><creatorcontrib>Lombardi, Carlo</creatorcontrib><creatorcontrib>Scardovi, Angela B.</creatorcontrib><creatorcontrib>Passantino, Andrea</creatorcontrib><creatorcontrib>Emdin, Michele</creatorcontrib><creatorcontrib>Passino, Claudio</creatorcontrib><creatorcontrib>Santolamazza, Caterina</creatorcontrib><creatorcontrib>Girola, Davide</creatorcontrib><creatorcontrib>Zaffalon, Denise</creatorcontrib><creatorcontrib>Vizza, Dario</creatorcontrib><creatorcontrib>De Martino, Fabiana</creatorcontrib><creatorcontrib>Agostoni, Piergiuseppe</creatorcontrib><creatorcontrib>on behalf of MECKI score research group</creatorcontrib><creatorcontrib>MECKI score research group</creatorcontrib><title>Does moderate hyperkalemia influence survival in HF? Insights from the MECKI score data base</title><title>International journal of cardiology</title><addtitle>Int J Cardiol</addtitle><description>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.
Aim of the study was to assess the prognostic impact of moderate hyperkalemia in chronic HFrEF optimally treated patients.
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.
Moderate hyperkalemia does not influence patients' outcome in a large cohort of ambulatory HFrEF patients.
•Hyperkalemia affects up to 18% of HFrEF patients leading to therapy down-titration.•The prognostic role of moderate hyperkalemia is still controversial.•We discovered that moderate hyperkalemia in HF is not associated to worst outcome.</description><subject>Heart Failure</subject><subject>Humans</subject><subject>Hyperkalemia</subject><subject>Hyperkalemia - diagnosis</subject><subject>Hyperkalemia - epidemiology</subject><subject>Potassium</subject><subject>Prognosis</subject><subject>Renin angiotensin aldosterone system inhibitor</subject><subject>Renin-Angiotensin System</subject><subject>Retrospective Studies</subject><subject>Stroke Volume</subject><issn>0167-5273</issn><issn>1874-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LAzEQhoMoWj_-gUiOXnZNstluclGktlqseNGbELLJxKbuR012C_57t1Q9ehoYnnde5kHonJKUEjq-WqV-ZXSwKSOMpUSmJCN7aERFwRNa5HwfjQasSHJWZEfoOMYVIYRLKQ7RUTamNOc8H6G3uxYirlsLQXeAl19rCB-6gtpr7BtX9dAYwLEPG7_R1bDCD7MbPG-if192EbvQ1rhbAn6aTh7nOJo2ALa607jUEU7RgdNVhLOfeYJeZ9OXyUOyeL6fT24XicnGrEvKwuVghbDM5YRnxnAL1AoHVGpWSFZmQgoxdnkp8tJymxFTSiKpE7bkQtvsBF3u7q5D-9lD7FTto4Gq0g20fVSs2H5LecEHlO9QE9oYAzi1Dr7W4UtRorZe1UrtvKqtV0WkGrwOsYufhr6swf6FfkUOwPUOgOHPjYegovFbd9YHMJ2yrf-_4RvfHYsD</recordid><startdate>20230115</startdate><enddate>20230115</enddate><creator>Toto, Federica</creator><creator>Salvioni, Elisabetta</creator><creator>Magrì, Damiano</creator><creator>Sciomer, Susanna</creator><creator>Piepoli, Massimo</creator><creator>Badagliacca, Roberto</creator><creator>Galotta, Arianna</creator><creator>Baracchini, Nikita</creator><creator>Paolillo, Stefania</creator><creator>Corrà, Ugo</creator><creator>Raimondo, Rosa</creator><creator>Lagioia, Rocco</creator><creator>Filardi, Pasquale Perrone</creator><creator>Iorio, Annamaria</creator><creator>Senni, Michele</creator><creator>Correale, Michele</creator><creator>Cicoira, Mariantonietta</creator><creator>Perna, Enrico</creator><creator>Metra, Marco</creator><creator>Guazzi, Marco</creator><creator>Limongelli, Giuseppe</creator><creator>Sinagra, Gianfranco</creator><creator>Parati, Gianfranco</creator><creator>Cattadori, Gaia</creator><creator>Bandera, Francesco</creator><creator>Bussotti, Maurizio</creator><creator>Mapelli, Massimo</creator><creator>Cipriani, Manlio</creator><creator>Bonomi, Alice</creator><creator>Cunha, Gonçalo</creator><creator>Re, Federica</creator><creator>Vignati, Carlo</creator><creator>Garascia, Andrea</creator><creator>Lombardi, Carlo</creator><creator>Scardovi, Angela B.</creator><creator>Passantino, Andrea</creator><creator>Emdin, Michele</creator><creator>Passino, Claudio</creator><creator>Santolamazza, Caterina</creator><creator>Girola, Davide</creator><creator>Zaffalon, Denise</creator><creator>Vizza, Dario</creator><creator>De Martino, Fabiana</creator><creator>Agostoni, Piergiuseppe</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20230115</creationdate><title>Does moderate hyperkalemia influence survival in HF? 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Insights from the MECKI score data base</atitle><jtitle>International journal of cardiology</jtitle><addtitle>Int J Cardiol</addtitle><date>2023-01-15</date><risdate>2023</risdate><volume>371</volume><spage>273</spage><epage>277</epage><pages>273-277</pages><issn>0167-5273</issn><eissn>1874-1754</eissn><abstract>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.
Aim of the study was to assess the prognostic impact of moderate hyperkalemia in chronic HFrEF optimally treated patients.
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.
Moderate hyperkalemia does not influence patients' outcome in a large cohort of ambulatory HFrEF patients.
•Hyperkalemia affects up to 18% of HFrEF patients leading to therapy down-titration.•The prognostic role of moderate hyperkalemia is still controversial.•We discovered that moderate hyperkalemia in HF is not associated to worst outcome.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>36115445</pmid><doi>10.1016/j.ijcard.2022.09.030</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0167-5273 |
| ispartof | International journal of cardiology, 2023-01, Vol.371, p.273-277 |
| issn | 0167-5273 1874-1754 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2715441474 |
| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Heart Failure Humans Hyperkalemia Hyperkalemia - diagnosis Hyperkalemia - epidemiology Potassium Prognosis Renin angiotensin aldosterone system inhibitor Renin-Angiotensin System Retrospective Studies Stroke Volume |
| title | Does moderate hyperkalemia influence survival in HF? Insights from the MECKI score data base |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T04%3A46%3A33IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Does%20moderate%20hyperkalemia%20influence%20survival%20in%20HF?%20Insights%20from%20the%20MECKI%20score%20data%20base&rft.jtitle=International%20journal%20of%20cardiology&rft.au=Toto,%20Federica&rft.aucorp=on%20behalf%20of%20MECKI%20score%20research%20group&rft.date=2023-01-15&rft.volume=371&rft.spage=273&rft.epage=277&rft.pages=273-277&rft.issn=0167-5273&rft.eissn=1874-1754&rft_id=info:doi/10.1016/j.ijcard.2022.09.030&rft_dat=%3Cproquest_cross%3E2715441474%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2715441474&rft_id=info:pmid/36115445&rft_els_id=S0167527322013407&rfr_iscdi=true |