Association of Potassium Level at Discharge with Long-Term Mortality in Hospitalized Patients with Heart Failure.
Yusuke MiuraSatoshi HiguchiTakashi KohnoYasuyuki ShiraishiMitsunobu KitamuraYuji NagatomoMakoto TakeiShintaro NakanoAyumi GodaKyoko SoejimaShun KohsakaTsutomu Yoshikawanull nullPublished in: Journal of clinical medicine (2022)
Dyskalemia (hypokalemia and hyperkalemia) is a common comorbidity of heart failure (HF). Although dyskalemia is associated with poor prognosis, different prognostic impacts of hypo- and hyperkalemia remain vastly unclear. This study investigated the association of dyskalemia with prognosis in HF patients, especially the mode of death and left ventricular ejection fraction (LVEF). The multicenter study included 3398 patients hospitalized for HF. Patients were divided into three groups based on serum potassium levels at discharge: hypokalemia (<3.5 mEq/L; n = 115 (3.4%)), normokalemia (3.5-5.0 mEq/L; n = 2960 (87.1%)), and hyperkalemia (≥5.0 mEq/L; n = 323 (9.5%)). Two-year all-cause, cardiac, and non-cardiac mortality was evaluated. Association of serum potassium with two-year mortality demonstrated a U-shaped curve, with a worse prognosis for patients with hypokalemia. All-cause mortality at two-years did not differ among the three groups. Hypokalemia was associated with 2-year cardiac death (adjusted hazard ratio (HR), 2.60; 95% confidence interval (CI), 1.20-5.64) in HF with reduced ejection fraction (HFrEF; LVEF < 40%), but not in non-HFrEF. Regardless of LVEF, hyperkalemia was not independently associated with any mortality. Hypokalemia was independently associated with cardiac death, particularly in HFrEF patients. Such an association was not observed in hyperkalemia regardless of LVEF.
Keyphrases
- ejection fraction
- end stage renal disease
- left ventricular
- heart failure
- chronic kidney disease
- aortic stenosis
- newly diagnosed
- poor prognosis
- prognostic factors
- peritoneal dialysis
- cardiovascular events
- risk factors
- patient reported outcomes
- acute myocardial infarction
- mass spectrometry
- acute heart failure
- high resolution
- mitral valve
- cardiac resynchronization therapy