Changes in serum potassium levels during hospitalization in patients with worsening heart failure and reduced ejection fraction (from the EVEREST trial)

The American Journal of Cardiology
Sadiya KhanEVEREST trial investigators

Abstract

Both hyperkalemia and hypokalemia may be related to heart failure (HF) therapy and are associated with adverse outcomes. Abnormalities in serum potassium levels in hospitalized patients with HF and reduced ejection fraction (EF) have not been previously investigated. A post hoc analysis was performed in 1,907 hospitalized patients with worsening HF and reduced EF in the placebo arm of the Efficacy of Vasopressin Antagonism in HF Outcome Study with Tolvaptan (EVEREST) trial. Serum potassium was measured at randomization and at discharge or day 7. The co-primary end points were all-cause mortality (ACM) and cardiovascular mortality or the first HF hospitalization (CVM + HFH). The association between inhospital change in potassium levels and time to outcomes was evaluated using multivariate Cox regression models. Study participants had a mean age of 65.6 ± 12.0 years and were on optimal guideline-directed medical therapies, including β blockers (77%), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (85%), and aldosterone antagonists (55%). Baseline potassium concentration was 4.3 ± 0.6 mEq/l, and hyperkalemia or hypokalemia was seen in 6.5% of the participants. On average, serum potassium level increased by ...Continue Reading

References

Jan 23, 2004·Journal of the American College of Cardiology·John E Macdonald, Allan D Struthers
Aug 6, 2004·The New England Journal of Medicine·David N JuurlinkDonald A Redelmeier
Mar 27, 2007·JAMA : the Journal of the American Medical Association·Marvin A KonstamUNKNOWN Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan (EVEREST) Investigators
Mar 27, 2007·JAMA : the Journal of the American Medical Association·Mihai GheorghiadeUNKNOWN Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan (EVEREST) Investigators
Aug 12, 2008·International Journal of Cardiology·A Brent AlperAli Ahmed
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Citations

May 24, 2016·North American Journal of Medical Sciences·Ashok DevkotaSaveena Manhas
Apr 29, 2016·European Journal of Heart Failure·Muthiah VaduganathanMihai Gheorghiade
Jun 10, 2016·Current Heart Failure Reports·Justin L Grodin
Oct 1, 2016·Journal of the American College of Cardiology·Chaudhry M S SarwarJaved Butler
Nov 9, 2016·The American Journal of Cardiology·Jasper TrompPeter van der Meer
Mar 7, 2019·European Heart Journal Supplements : Journal of the European Society of Cardiology·Jasper Tromp, Peter van der Meer
Dec 5, 2019·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Angela Yee-Moon Wang
Jun 9, 2018·Journal of Nephrology·Luca De NicolaStefano Bianchi
Oct 31, 2017·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Matthieu LegrandUNKNOWN GREAT (Global Research on Acute Conditions Team) Network and INI-CRCT (Investigation Network Initiative-Cardiovascular and R
Jul 25, 2019·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Kevin F O'SullivanTara Lagu
Oct 19, 2020·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Pedro Caravaca PerezJuan F Delgado
Oct 26, 2018·Cardiorenal Medicine·Luca Di LulloAntonio Bellasi

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