Hyperkalemia in heart failure patients in Spain and its impact on guidelines and recommendations: ESC-EORP-HFA Heart Failure Long-Term Registry

被引：4

作者：

Crespo-Leiro, Maria G. ^{[1
,2
]}

Barge-Caballero, Eduardo ^{[1
,2
]}

Segovia-Cubero, Javier ^{[2
,3
]}

Gonzalez-Costello, Jose ^{[4
]}

Lopez-Fernandez, Silvia ^{[5
]}

Manuel Garcia-Pinilla, Jose ^{[2
,6
]}

Almenar-Bonet, Luis ^{[7
]}

De Juan-Baguda, Javier ^{[8
]}

Roig-Minguell, Eulalia ^{[2
,9
]}

Bayes-Genis, Antoni ^{[2
,10
]}

Sanz-Julve, Marisa ^{[11
]}

Luis Lambert-Rodriguez, Jose ^{[12
]}

Lara-Padron, Antonio ^{[13
]}

Perez-Ruiz, Jose Maria ^{[14
]}

Fernandez-Vivancos Marquina, Carla ^{[15
]}

de la Fuente-Galan, Luis ^{[16
]}

Varela-Roman, Alfonso ^{[2
,17
]}

Torres-Calvo, Francisco ^{[18
]}

Andres-Novales, Javier ^{[19
]}

Escudero-Gonzalez, Aida ^{[20
]}

Pascual-Figal, Domingo A. ^{[2
,21
]}

Ridocci-Soriano, Francisco ^{[22
]}

Sahuquillo-Martinez, Ana ^{[23
]}

Bierge-Valero, David ^{[24
]}

Epelde-Gonzalo, Francisco ^{[25
]}

Carlos Gallego-Page, Juan ^{[26
]}

Dalmau Gonzalez-Gallarza, Regina ^{[2
,27
]}

Bover-Freire, Ramon ^{[2
,28
]}

Quiles-Granado, Juan ^{[29
]}

Pietro Maggioni, Aldo ^{[30
,31
]}

Lund, Lars H. ^{[32
,33
]}

Muniz, Javier ^{[2
,34
]}

Delgado-Jimenez, Juan ^{[2
,8
]}

机构：

[1] Univ Coruna UDC, Complexo Hosp Univ A Coruna CHUAC, Inst Invest Biomed A Coruna INIBIC,SERGAS, Serv Cardiol,Unidad Insuficiencia Cardiaca & Tras, La Coruna, Spain

[2] Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Cardiovasc CIB, Madrid, Spain

[3] Hosp Univ Puerta Hierro, Serv Cardiol, Unidad Insuficiencia Cardiaca Avanzada Trasplante, Madrid, Spain

[4] Hosp Univ Bellvitge IDIBELL, Serv Cardiol, Unidad Insuficiencia Cardiaca Avanzada & Trasplan, Barcelona, Spain

[5] Hosp Univ Virgen Nieves, Serv Cardiol, Unidad Insuficiencia Cardiaca, Granada, Spain

[6] Hosp Univ Virgen Victoria, IBIMA, Unidad Insuficiencia Cardiaca & Cardiopatias Fami, Unidad Gest Clin Cardiol & Cirugia Cardiovasc, Malaga, Spain

[7] Hosp Univ & Politecn La Fe, Serv Cardiol, Unidad Insuficiencia Cardiaca & Trasplante, Valencia, Spain

[8] Hosp Univ 12 Octubre, Serv Cardiol, Unidad Insuficiencia Cardiaca & Trasplante, Madrid, Spain

[9] Hosp Santa Creu & Sant Pau, Unidad Insuficiencia Cardiaca & Trasplante, Serv Cardiol, Barcelona, Spain

[10] Hosp Badalona Germans Trias & Pujol, Serv Cardiol, Barcelona, Spain

[11] Hosp Univ Miguel Servet, Serv Cardiol, Unidad Insuficiencia Cardiaca Avanzada & Trasplan, Zaragoza, Spain

[12] Hosp Univ Cent Asturias, Unidad Insuficiencia Cardiaca Avanzada & Trasplan, Oviedo, Asturias, Spain

[13] Hosp Univ Canarias, Serv Cardiol, Santa Cruz De Tenerife, Canarias, Spain

[14] Hosp Univ Reg Malaga, Serv Cardiol, IBIMA, Unidad Especializada Insuficiencia Cardiaca,Unida, Malaga, Spain

[15] Hosp Univ Virgen Macarena, Serv Cardiol, Seville, Spain

[16] Hosp Clin Univ Valladolid, Serv Cardiol, Unidad Insuficiencia Cardiaca Avanzada & Trasplan, Valladolid, Spain

[17] Univ Santiago de Compostela USC, Complexo Hosp Univ Santiago Compostela CHUS, Unidad Insuficiencia Cardiaca, SERGAS, Santiago De Compostela, A Coruna, Spain

[18] Hosp Costa Sol, Unidad Insuficiencia Cardiaca, Malaga, Spain

[19] Hosp San Eloy, Serv Cardiol, Baracaldo, Vizcaya, Spain

[20] Hosp Povisa, Serv Cardiol, Vigo, Pontevedra, Spain

[21] Univ Murcia, Hosp Univ Virgen Arrixaca, Serv Cardiol, IMIB Arrixaca, Murcia, Spain

[22] Consorcio Hosp Gen Univ Valencia, Serv Cardiol, Valencia, Spain

[23] Hosp Manacor, Serv Cardiol, Manacor, Islas Baleares, Spain

[24] Hosp Verge Cinta, Serv Cardiol, Unidad Insuficiencia Cardiaca, Tarragona, Spain

[25] Hosp Univ Parc Tauli, Unidad Estancia Corta, Barcelona, Spain

[26] Complejo Hosp Albacete, Serv Cardiol, Albacete, Spain

[27] Hosp Univ La Paz, Hosp Cantoblanco, Serv Cardiol, Madrid, Spain

[28] Hosp Univ Clin San Carlos, Serv Cardiol, Programa Insuficiencia Cardiaca, Madrid, Spain

[29] Hosp Univ San Juan, Serv Cardiol, Alicante, Spain

[30] Assoc Nazl Med Cardiol Ospedalieri ANMCO, Res Ctr, Florencia, Italy

[31] European Soc Cardiol ESC, EuroObservat Res Program EORP, Sophia Antipolis, France

[32] Karolinska Univ Hosp, Karolinska Inst, Dept Med, Solna, Sweden

[33] Karolinska Univ Hosp, Heart & Vasc Theme, Solna, Sweden

[34] Univ A Coruna, Inst Univ Ciencias Salud, Inst Invest Biomed A Coruna INIBIC, La Coruna, Spain

来源：

REVISTA ESPANOLA DE CARDIOLOGIA | 2020年 / 73卷 / 04期

关键词：

Hyperkalemia; Heart failure; Real-world evidence; Follow-up; SERUM POTASSIUM; ASSOCIATION; ENALAPRIL; SURVIVAL; OUTCOMES; EPLERENONE; MANAGEMENT; MORTALITY; DIAGNOSIS; EFFICACY;

D O I：

10.1016/j.recesp.2019.05.004

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction and objectives: Hyperkalemia is a growing concern in the treatment of patients with heart failure and reduced ejection fraction because it limits the use of effective drugs. We report estimates of the magnitude of this problem in routine clinical practice in Spain, as well as changes in potassium levels during follow-up and associated factors. Methods: This study included patients with acute (n = 881) or chronic (n = 3587) heart failure recruited in 28 Spanish hospitals of the European heart failure registry of the European Society of Cardiology and followed up for 1 year. Various outcomes were analyzed, including changes in serum potassium levels and their impact on treatment. Results: Hyperkalemia (K+ > 5.4 mEq/L) was identified in 4.3% (95%CI, 3.7%-5.0%) and 8.2% (6.5%-10.2%) of patients with chronic and acute heart failure, respectively, and was responsible for 28.9% of all cases of contraindication to mineralocorticoid receptor antagonist use and for 10.8% of all cases of failure to reach the target dose. Serum potassium levels were not recorded in 291 (10.8%) of the 2693 chronic heart failure patients with reduced ejection fraction. During follow-up, potassium levels increased in 179 of 1431 patients (12.5%, 95%CI, 10.8%-14.3%). This increase was directly related to age, diabetes, and history of stroke and was inversely related to history of hyperkalemia. Conclusions: This study highlights the magnitude of the problem of hyperkalemia in patients with heart failure in everyday clinical practice and the need to improve monitoring of this factor in these patients due to its interference with the possibility of receiving optimal treatment. (C) 2019 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.

引用

页码：313 / 323

页数：11

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