Hypokalaemia and outcomes in older patients hospitalized for heart failure
Abstract Aims Hypokalaemia is a risk factor for ventricular arrhythmias and sudden death in ambulatory patients with chronic heart failure (HF). The objective of this study was to examine the association between hypokalaemia and outcomes in hospitalized patients with decompensated HF in whom sudden...
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Wiley
2020-06-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.12666 |
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| author | Miroslava Valentova Samir Patel Phillip H. Lam Charles Faselis Cherinne Arundel Gregg C. Fonarow Yan Cheng Richard M. Allman Stephan vonHaehling Stefan D. Anker Ali Ahmed |
| author_facet | Miroslava Valentova Samir Patel Phillip H. Lam Charles Faselis Cherinne Arundel Gregg C. Fonarow Yan Cheng Richard M. Allman Stephan vonHaehling Stefan D. Anker Ali Ahmed |
| author_sort | Miroslava Valentova |
| collection | DOAJ |
| description | Abstract Aims Hypokalaemia is a risk factor for ventricular arrhythmias and sudden death in ambulatory patients with chronic heart failure (HF). The objective of this study was to examine the association between hypokalaemia and outcomes in hospitalized patients with decompensated HF in whom sudden death is less common. Methods and results Of the 5881 hospitalized patients with HF, 1052 had consistent hypokalaemia (both admission and discharge serum potassium <4.0 mmol/L), and 2538 had consistent normokalaemia (both admission and discharge serum potassium 4.0–5.0 mmol/L). Propensity scores for consistent hypokalaemia, estimated for each of 3590 (1052 + 2538) patients, were used to assemble a matched cohort of 971 pairs of patients with consistent hypokalaemia vs. consistent normokalaemia, balanced on 54 baseline characteristics (mean age, 75 years; 60% women; 28% African American). We repeated the above process to assemble 2327 pairs of patients with discharge potassium <4.0 vs. 4.0–5.0 mmol/L and 449 pairs of patients with discharge serum potassium <3.5 vs. 4.0–5.0 mmol/L. Hazard ratios (HR) and 95% confidence intervals (CIs) associated with hypokalaemia were estimated in matched cohorts. 30 day all‐cause mortality occurred in 5% and 4% of patients with consistent normokalaemia vs. consistent hypokalaemia, respectively (HR, 0.78; 95% CI, 0.52–1.18; P = 0.241). HRs (95% CI) for 30 day mortality associated with discharge serum potassium <4.0 and <3.5 mmol/L were 0.90 (0.70–1.16; P = 0.419) and 1.69 (0.94–3.04; P = 0.078), respectively. Hypokalaemia (<4.0 or <3.5 mmol/L) had no association with long‐term mortality or other outcomes. Conclusions In hospitalized older patients with HF, compared with normokalaemia (serum potassium 4.0–5.0 mmol/L), hypokalaemia (<4.0 or <3.5 mmol/L) had no significant associations with outcomes. |
| format | Article |
| id | doaj-art-ddfd85d160104a4392596f7812afbad4 |
| institution | Kabale University |
| issn | 2055-5822 |
| language | English |
| publishDate | 2020-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-ddfd85d160104a4392596f7812afbad42025-02-03T10:25:46ZengWileyESC Heart Failure2055-58222020-06-017379480310.1002/ehf2.12666Hypokalaemia and outcomes in older patients hospitalized for heart failureMiroslava Valentova0Samir Patel1Phillip H. Lam2Charles Faselis3Cherinne Arundel4Gregg C. Fonarow5Yan Cheng6Richard M. Allman7Stephan vonHaehling8Stefan D. Anker9Ali Ahmed10Department of Cardiology and Pneumology University Medical Center Göttingen Göttingen GermanyDepartment of Medicine Veterans Affairs Medical Center Washington DC USADepartment of Medicine Veterans Affairs Medical Center Washington DC USADepartment of Medicine Veterans Affairs Medical Center Washington DC USADepartment of Medicine Veterans Affairs Medical Center Washington DC USADivision of Cardiology University of California Los Angeles CA USADepartment of Medicine Veterans Affairs Medical Center Washington DC USADepartment of Medicine George Washington University Washington DC USADepartment of Cardiology and Pneumology University Medical Center Göttingen Göttingen GermanyDepartment of Cardiology (CVK) and Berlin Institute of Health Center for Regenerative Therapies (BCRT) German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin Berlin Berlin GermanyDepartment of Medicine Veterans Affairs Medical Center Washington DC USAAbstract Aims Hypokalaemia is a risk factor for ventricular arrhythmias and sudden death in ambulatory patients with chronic heart failure (HF). The objective of this study was to examine the association between hypokalaemia and outcomes in hospitalized patients with decompensated HF in whom sudden death is less common. Methods and results Of the 5881 hospitalized patients with HF, 1052 had consistent hypokalaemia (both admission and discharge serum potassium <4.0 mmol/L), and 2538 had consistent normokalaemia (both admission and discharge serum potassium 4.0–5.0 mmol/L). Propensity scores for consistent hypokalaemia, estimated for each of 3590 (1052 + 2538) patients, were used to assemble a matched cohort of 971 pairs of patients with consistent hypokalaemia vs. consistent normokalaemia, balanced on 54 baseline characteristics (mean age, 75 years; 60% women; 28% African American). We repeated the above process to assemble 2327 pairs of patients with discharge potassium <4.0 vs. 4.0–5.0 mmol/L and 449 pairs of patients with discharge serum potassium <3.5 vs. 4.0–5.0 mmol/L. Hazard ratios (HR) and 95% confidence intervals (CIs) associated with hypokalaemia were estimated in matched cohorts. 30 day all‐cause mortality occurred in 5% and 4% of patients with consistent normokalaemia vs. consistent hypokalaemia, respectively (HR, 0.78; 95% CI, 0.52–1.18; P = 0.241). HRs (95% CI) for 30 day mortality associated with discharge serum potassium <4.0 and <3.5 mmol/L were 0.90 (0.70–1.16; P = 0.419) and 1.69 (0.94–3.04; P = 0.078), respectively. Hypokalaemia (<4.0 or <3.5 mmol/L) had no association with long‐term mortality or other outcomes. Conclusions In hospitalized older patients with HF, compared with normokalaemia (serum potassium 4.0–5.0 mmol/L), hypokalaemia (<4.0 or <3.5 mmol/L) had no significant associations with outcomes.https://doi.org/10.1002/ehf2.12666Heart failurePotassiumMortalityHospitalizationPropensity score |
| spellingShingle | Miroslava Valentova Samir Patel Phillip H. Lam Charles Faselis Cherinne Arundel Gregg C. Fonarow Yan Cheng Richard M. Allman Stephan vonHaehling Stefan D. Anker Ali Ahmed Hypokalaemia and outcomes in older patients hospitalized for heart failure ESC Heart Failure Heart failure Potassium Mortality Hospitalization Propensity score |
| title | Hypokalaemia and outcomes in older patients hospitalized for heart failure |
| title_full | Hypokalaemia and outcomes in older patients hospitalized for heart failure |
| title_fullStr | Hypokalaemia and outcomes in older patients hospitalized for heart failure |
| title_full_unstemmed | Hypokalaemia and outcomes in older patients hospitalized for heart failure |
| title_short | Hypokalaemia and outcomes in older patients hospitalized for heart failure |
| title_sort | hypokalaemia and outcomes in older patients hospitalized for heart failure |
| topic | Heart failure Potassium Mortality Hospitalization Propensity score |
| url | https://doi.org/10.1002/ehf2.12666 |
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