Khibar Salah1, Yigal M Pinto2, Luc W Eurlings3, Marco Metra4, Susan Stienen2, Carlo Lombardi4, Jan G Tijssen2, Wouter E Kok2. 1. Academic Medical Center, University of Amsterdam, Heart failure Research Center & Department of Cardiology, Amsterdam, the Netherlands. Electronic address: k.salah@amc.uva.nl. 2. Academic Medical Center, University of Amsterdam, Heart failure Research Center & Department of Cardiology, Amsterdam, the Netherlands. 3. University Hospital Maastricht, Department of Cardiology, Maastricht, the Netherlands. 4. University of Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Cardiology, Brescia, Italy.
Abstract
BACKGROUND: Limited data exist for the role of serum potassium changes during hospitalization for acute decompensated heart failure (ADHF). The present study investigated the long-term prognostic value of potassium changes during hospitalization in patients admitted for ADHF. METHODS: Our study is a pooled individual patient data analysis assembled from 3 prospective cohorts comprising 754 patients hospitalized for ADHF. The endpoint was all-cause mortality within 180 days after discharge. Serum potassium levels and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were measured at admission and at discharge. RESULTS: A percentage decrease >15% in serum potassium levels occurred in 96 (13%) patients, and an absolute decrease of >0.7 mmol/L in serum potassium levels occurred in 85 (12%) patients; and both were predictors of poor outcome independent of admission or discharge serum potassium. After the addition of other strong predictors of mortality-a 30% change in NT-proBNP during hospitalization, discharge levels of NT-proBNP, renal markers, and other relevant clinical variables-the multivariate hazard ratio of serum potassium percentage reduction of >15% remained an independent predictor of 180-day mortality (hazard ratio 2.06, 95% CI 1.14-3.73). CONCLUSIONS: A percentage serum potassium decline of >15% is an independent predictor of 180-day all-cause mortality on top of baseline potassium levels, NT-proBNP levels, renal variables, and other relevant clinical variables. This suggest that patients hospitalized for ADHF with a decline of >15% in serum potassium levels are at risk and thus monitoring and regulating of serum potassium level during hospitalization are needed in these patients.
BACKGROUND: Limited data exist for the role of serum potassium changes during hospitalization for acute decompensated heart failure (ADHF). The present study investigated the long-term prognostic value of potassium changes during hospitalization in patients admitted for ADHF. METHODS: Our study is a pooled individual patient data analysis assembled from 3 prospective cohorts comprising 754 patients hospitalized for ADHF. The endpoint was all-cause mortality within 180 days after discharge. Serum potassium levels and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were measured at admission and at discharge. RESULTS: A percentage decrease >15% in serum potassium levels occurred in 96 (13%) patients, and an absolute decrease of >0.7 mmol/L in serum potassium levels occurred in 85 (12%) patients; and both were predictors of poor outcome independent of admission or discharge serum potassium. After the addition of other strong predictors of mortality-a 30% change in NT-proBNP during hospitalization, discharge levels of NT-proBNP, renal markers, and other relevant clinical variables-the multivariate hazard ratio of serum potassium percentage reduction of >15% remained an independent predictor of 180-day mortality (hazard ratio 2.06, 95% CI 1.14-3.73). CONCLUSIONS: A percentage serum potassium decline of >15% is an independent predictor of 180-day all-cause mortality on top of baseline potassium levels, NT-proBNP levels, renal variables, and other relevant clinical variables. This suggest that patients hospitalized for ADHF with a decline of >15% in serum potassium levels are at risk and thus monitoring and regulating of serum potassium level during hospitalization are needed in these patients.
Authors: Kevin F O'Sullivan; Mohammad Amin Kashef; Alexander B Knee; Alexander S Roseman; Penelope S Pekow; Mihaela S Stefan; Meng-Shiou Shieh; Quinn R Pack; Peter K Lindenauer; Tara Lagu Journal: J Hosp Med Date: 2019-07-24 Impact factor: 2.960
Authors: Pedro Caravaca Perez; José R González-Juanatey; Jorge Nuche; Laura Morán Fernández; David Lora Pablos; Jesús Alvarez-García; Ramón Bascompte Claret; Manuel Martínez Selles; Rafael Vázquez García; Luis Martínez Dolz; Marta Cobo-Marcos; Domingo Pascual Figal; Maria G Crespo-Leiro; Julio Nuñez Villota; Juan Cinca Cuscullola; Juan F Delgado Journal: Clin Res Cardiol Date: 2020-10-17 Impact factor: 5.460