Does moderate hyperkalemia influence survival in HF? Insights from the MECKI score data base.
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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, MECKI score research group
Аннотация
OBJECTIVES: Aim of the study was to assess the prognostic impact of moderate hyperkalemia in chronic HFrEF optimally treated patients.
METHODS AND RESULTS: 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.
CONCLUSIONS: Moderate hyperkalemia does not influence patients' outcome in a large cohort of ambulatory HFrEF patients.