Prevalence, Incidence, and Outcomes of Hyperkalaemia in Patients with Chronic Heart Failure and Reduced Ejection Fraction from a Spanish Multicentre Study: SPANIK-HF Design and Baseline Characteristics
Por:
Delgado-Jimenez, JF, Segovia-Cubero, J, Almenar-Bonet, L, de Juan-Baguda, J, Lara-Padron, A, Garcia-Pinilla, JM, Bonilla-Palomas, JL, Lopez-Fernandez, S, Mirabet-Perez, S, Gomez-Otero, I, Castro-Fernandez, A, Diaz-Molina, B, Goirigolzarri-Artaza, J, Rincon-Diaz, LM, Pascual-Figal, DA, Anguita-Sanchez, M, Muniz, J, Crespo-Leiro, MG
Publicada:
1 mar 2022
Resumen:
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(2), 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.
Filiaciones:
Delgado-Jimenez, JF:
Hosp Univ 12 Octubre, Inst Invest, Madrid, Spain
Hosp Univ 12 Octubre, Serv Cardiol, Madrid, Spain
Ctr Invest Biomed Red Cardiovasc CIBERCV, Madrid, Spain
Segovia-Cubero, J:
Ctr Invest Biomed Red Cardiovasc CIBERCV, Madrid, Spain
Hosp Univ Puerta de Hierro, Serv Cardiol, Madrid, Spain
Almenar-Bonet, L:
Ctr Invest Biomed Red Cardiovasc CIBERCV, Madrid, Spain
Hosp Univ La Fe, Serv Cardiol, Valencia, Spain
de Juan-Baguda, J:
Hosp Univ 12 Octubre, Inst Invest, Madrid, Spain
Hosp Univ 12 Octubre, Serv Cardiol, Madrid, Spain
Ctr Invest Biomed Red Cardiovasc CIBERCV, Madrid, Spain
Lara-Padron, A:
Hosp San Juan Cruz, Serv Cardiol, Jaen, Spain
Garcia-Pinilla, JM:
Ctr Invest Biomed Red Cardiovasc CIBERCV, Madrid, Spain
Bonilla-Palomas, JL:
Hosp San Juan Cruz, Serv Cardiol, Jaen, Spain
Lopez-Fernandez, S:
Hosp Univ Virgen Nieves, Serv Cardiol, Granada, Spain
Mirabet-Perez, S:
Ctr Invest Biomed Red Cardiovasc CIBERCV, Madrid, Spain
Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, 08041, Spain
Gomez-Otero, I:
Ctr Invest Biomed Red Cardiovasc CIBERCV, Madrid, Spain
Hosp Univ Virgen Victoria, Serv Cardiol, Int Business Informat Management Assoc, Malaga, Spain
Castro-Fernandez, A:
Hosp San Juan Cruz, Serv Cardiol, Jaen, Spain
Diaz-Molina, B:
Ctr Invest Biomed Red Cardiovasc CIBERCV, Madrid, Spain
Hosp Univ Virgen Nieves, Serv Cardiol, Granada, Spain
Goirigolzarri-Artaza, J:
Ctr Invest Biomed Red Cardiovasc CIBERCV, Madrid, Spain
Hosp Univ Clin San Carlos, Serv Cardiol, Madrid, Spain
Rincon-Diaz, LM:
Ctr Invest Biomed Red Cardiovasc CIBERCV, Madrid, Spain
Hosp Ramon & Cajal, Serv Cardiol, Madrid, Spain
Pascual-Figal, DA:
Ctr Invest Biomed Red Cardiovasc CIBERCV, Madrid, Spain
Hosp Clin Univ Virgen de la Arrixaca, Serv Cardiol, Murcia, Spain
Anguita-Sanchez, M:
Hosp Univ Reina Sofia, Serv Cardiol, Cordoba, Spain
Muniz, J:
Univ Coruna UDC, Inst Invest Biomed A Coruna, La Coruna, Spain
Crespo-Leiro, MG:
Ctr Invest Biomed Red Cardiovasc CIBERCV, Madrid, Spain
Complexo Hosp Univ, Serv Cardiol, La Coruna, Spain
Hosp Univ Canarias, Serv Cardiol, Santa Cruz De Tenerife, Spain
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