Abstract 18551: Impact of Potassium on Survival in Chronic Heart Failure Patients
Introduction: Diuretic therapy is frequently prescribed to patients suffering from chronic heart failure and carries an increased risk of impaired serum potassium homeostasis. Furthermore, chronic heart failure patients are vulnerable to serum potassium deviations.
Hypothesis: We examined the association between different levels of potassium and mortality among patients with chronic heart failure.
Methods: From Danish National registries, we identified patients with chronic heart failure who had a serum potassium measurement after treatment with both loop diuretics and angiotensin converting enzyme inhibitors/angiotensin-II receptor blockers. All-cause mortality was examined according to seven predefined potassium levels: <3.5mmol/L, 3.5-4mmol/L, 4-4.2mmol/L, 4.2-4.4mmol/L, 4.4-4.7mmol/L, 4.7-5mmol/L and >5mmol/L. Follow-up was 90 days from the potassium measurement. We estimated the hazard ratio (HR) of death using a multivariable adjusted Cox regression analysis with serum potassium level at 4.2-4.4mmol/L as reference.
Results: In total, 19,579 patients were included in the study. Median age was 75.8 years [interquartile range 67.0-82.6]. Most patients were male (57.4%). The 90-days mortality rates were 14.0%, 7.1%, 6.7%, 5.2%, 5.3%, 7.1% and 13.2% for the seven serum potassium level groups (<3.5mmol/L, 3.5-4mmol/L, 4-4.2mmol/L, 4.2-4.4mmol/L, 4.4-4.7mmol/L, 4.7-5mmol/L and >5mmol/L, respectively).
The adjusted cox model showed an increased risk of death for patients having serum potassium levels at <3.5mmol/L (HR: 2.89; 95%CI: 2.21-3.79), 3.5-4mmol/L (HR: 1.37; 95%CI: 1.12-1.68), 4-4.2mmol/L (HR: 1.28; 95%CI: 1.03-1.58) and >5mmol/L (HR: 2.03; 95%CI: 1.66-2.47). Serum potassium levels at 4.4-4.7mmol/L and 4.7-5mmol/L were not associated with an increased risk of death (HR: 0.99; 95%CI: 0.82-1.20 and HR: 1.20; 95%CI: 0.99-1.46, respectively).
Conclusions: Potassium levels outside the normal serum potassium range of 3.5-5.0mmol/L were associated with an increased risk of death. In addition, serum potassium levels within the lower levels of the normal serum potassium range (3.5-4.2mmol/L) posed an increased risk of death for chronic heart failure patients receiving diuretic therapy and should be avoided.
Author Disclosures: M. Aldahl: None. A.C. Jensen: None. L. Davidsen: None. M.A. Eriksen: None. S.M. Hansen: None. B.J. Nielsen: None. M.L. Krogager: None. L. Køber: Honoraria; Modest; Novartis, Sanofi. C. Torp-Pedersen: Research Grant; Modest; Bristol-Myers Squibb. Consultant/Advisory Board; Modest; Cardiome, Merck, Sanofi, Daiichi. P. Søgaard: Research Grant; Modest; Biotronic, St. Jude, Novartis, Bayer, EBR system, GE Health care. Consultant/Advisory Board; Modest; Biotronic.
- © 2016 by American Heart Association, Inc.