Hyperkalemia in heart failure patients in Spain and its impact on guidelines and recommendations: ESC-EORP-HFA Heart Failure Long-Term Registry.
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Crespo-Leiro María G, Barge-Caballero Eduardo, Segovia-Cubero Javier, González-Costello José, López-Fernández Silvia, García-Pinilla José Manuel, Almenar-Bonet Luis, de Juan-Bagudá Javier, Roig-Minguell Eulalia, Bayés-Genís Antoni, Sanz-Julve Marisa, Lambert-Rodríguez José Luis, Lara-Padrón Antonio, Pérez-Ruiz José María, Fernández-Vivancos Marquina Carla, de la Fuente-Galán Luis, Varela-Román Alfonso, Torres-Calvo Francisco, Andrés-Novales Javier, Escudero-González Aida, Pascual-Figal Domingo A, Ridocci-Soriano Francisco, Sahuquillo-Martínez Ana, Bierge-Valero David, Epelde-Gonzalo Francisco, Gallego-Page Juan Carlos, Dalmau González-Gallarza Regina, Bover-Freire Ramón, Quiles-Granado Juan, Maggioni Aldo Pietro, Lund Lars H, Muñiz Javier, Delgado-Jiménez Juan
Аннотация
METHODS: This study included patients with acute (n=881) or chronic (n=3587) heart failure recruited in 28 Spanish hospitals of the European heart failure registry of the European Society of Cardiology and followed up for 1 year. Various outcomes were analyzed, including changes in serum potassium levels and their impact on treatment.
RESULTS: Hyperkalemia (K+> 5.4 mEq/L) was identified in 4.3% (95%CI, 3.7%-5.0%) and 8.2% (6.5%-10.2%) of patients with chronic and acute heart failure, respectively, and was responsible for 28.9% of all cases of contraindication to mineralocorticoid receptor antagonist use and for 10.8% of all cases of failure to reach the target dose. Serum potassium levels were not recorded in 291 (10.8%) of the 2693 chronic heart failure patients with reduced ejection fraction. During follow-up, potassium levels increased in 179 of 1431 patients (12.5%, 95%CI, 10.8%-14.3%). This increase was directly related to age, diabetes, and history of stroke and was inversely related to history of hyperkalemia.
CONCLUSIONS: This study highlights the magnitude of the problem of hyperkalemia in patients with heart failure in everyday clinical practice and the need to improve monitoring of this factor in these patients due to its interference with the possibility of receiving optimal treatment.