Serum potassium decline during hospitalization for acute decompensated heart failure is a predictor of 6-month mortality, independent of N-terminal pro–B-type natriuretic peptide levels: An individual patient data analysis - 16/09/15
, Yigal M. Pinto, MD, PhD a, Luc W. Eurlings, MD b, Marco Metra, MD, PhD c, Susan Stienen, MD a, Carlo Lombardi, MD c, Jan G. Tijssen, PhD a, Wouter E. Kok, MD, PhD aRésumé |
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.
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| Financial support: none. |
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| Conflict of Interest: LWME and YMP received research funding for their original study from the Dutch Heart Foundation, Dutch Organisation for Scientific Research, the Royal Dutch Academy of Arts and Sciences—Interuniversity Cardiology Institute of the Netherlands, Pfizer, Astra-Zeneca, Medtronic, and Roche Diagnostics. YMP is a recipient of payments for lectures including service on speakers bureaus and research grants from ROCHE Diagnostics. YMP has an unrelated biomarker patent and stocks in a University spinoff company. WEMK received a grant from the Dutch Heart Foundation for an unrelated study. MM is a member of the board in Corthera and Novartis and receives payment for lectures including service on speakers bureaus from Servier or Stroder. All other authors have reported that they have no relationships to disclose. |
Vol 170 - N° 3
P. 531 - septembre 2015 Retour au numéro
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