Prevalence, Incidence, and Outcomes of Hyperkalaemia in Patients with Chronic Heart Failure and Reduced Ejection Fraction from a Spanish Multicentre Study

Hyperkalaemia is a growing concern in the treatment of patients with heart failure and reduced ejection fraction (HFrEF) as it limits the use of some prognostic-modifying drugs and has a negative impact on prognosis. The objective of the present study was to estimate the prevalence of hyperkalaemia...

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Detalles Bibliográficos
Autores: Delgado-Jiménez, Juan Francisco|||0000-0002-5401-8324, Segovia, Javier|||0000-0002-4606-3416, Almenar Bonet, Luis|||0000-0002-7710-361X, de Juan Bagudá, Javier|||0000-0002-9847-687X, Lara-Padrón, Antonio, García Pinilla, José Manuel|||0000-0001-5999-5741, Bonilla-Palomas, Juan Luis, López-Fernández, Silvia, Mirabet Pérez, Sonia|||0000-0001-5955-2748, Gómez-Otero, Inés, Castro-Fernández, Antonio, Díaz-Molina, Beatriz|||0000-0002-7773-8121, Goirigolzarri-Artaza, Josebe, Rincón-Díaz, Luis Miguel|||0000-0003-1819-5742, Pascual-Figal, DA.|||0000-0002-4993-9540, Anguita-Sánchez, Manuel|||0000-0001-7875-7263, Muñiz, Javier|||0000-0002-3087-2067, Crespo-Leiro, Maria Generosa|||0000-0002-3085-167X
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:277680
Acceso en línea:https://ddd.uab.cat/record/277680
https://dx.doi.org/urn:doi:10.3390/jcm11051170
Access Level:acceso abierto
Palabra clave:Hyperkalaemia
Heart failure
Medical treatment
Descripción
Sumario:Hyperkalaemia is a growing concern in the treatment of patients with heart failure and reduced ejection fraction (HFrEF) as it limits the use of some prognostic-modifying drugs and has a negative impact on prognosis. The objective of the present study was to estimate the prevalence of hyperkalaemia in outpatients with HFrEF and its impact on achieving optimal medical treatment. For this purpose, a multicentre, prospective, and observational study was carried out on consecutive HFrEF patients who were monitored as outpatients in heart failure (HF) units and who, in the opinion of their doctor, received optimal medical treatment. A total of 565 HFrEF patients were included from 16 specialised HF units. The mean age was 66 ± 12 years, 78% were male, 45% had an ischemic cause, 39% had atrial fibrillation, 43% were diabetic, 42% had a glomerular filtration rate < 60 mL/min/1.7 m, and the mean left ventricular ejection fraction was 31 ± 7%. Treatment at the study entry included: 76% on diuretics, 13% on ivabradine, 7% on digoxin, 18.9% on angiotensin-conversing enzyme inhibitors (ACEi), 11.3% on angiotensin receptors blockers (ARBs), 63.8% on angiotensin-neprilysin inhibitors (ARNi), 78.5% on mineralocorticoid receptor antagonists (MRAs), and 92.9% on beta-blockers. Potassium levels in the baseline analysis were: ≤5 mEq/L = 80.5%, 5.1-5.4 mEq/L = 13.8%, 5.5-5.9 mEq/L = 4.6%, and ≥6 mEq/L = 1.06%. Hyperkalaemia was the reason for not prescribing or reaching the target dose of an MRAs in 34.8% and 12.5% of patients, respectively. The impact of hyperkalaemia on not prescribing or dropping below the target dose in relation to ACEi, ARBs, and ARNi was significantly less. In conclusion, hyperkalaemia is a frequent problem in the management of patients with HFrEF and a limiting factor in the optimisation of medical treatment.

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