November 21, 2019
Hyperkalemia was behind more than a quarter of cases of contraindication to mineralocorticoid receptor antagonist use in a group of patients with heart failure in Spain, according to a recent study.
“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,” researchers wrote.
The study included 881 patients with acute heart failure and 3587 patients with chronic heart failure from 28 hospitals in Spain.
Overall, 8.2% of patients with acute heart failure and 4.3% of patients with chronic heart failure had hyperkalemia, according to the study. Hyperkalemia was responsible for 28.9% of all cases of contraindication to mineralocorticoid receptor antagonists and 10.8% of all cases of failure to reach the target dose.
Over a year of follow-up, 12.5% of 1431 patients had potassium levels increase. Increased potassium levels were directly related to age, diabetes, and history of stroke, researchers reported, and inversely related to a history of hyperkalemia.
“This study highlights the magnitude of the problem of hyperkalemia in patients with heart failure in everyday clinical practice,” researchers concluded, “and the need to improve monitoring of this factor in these patients due to its interference with the possibility of receiving optimal treatment.”
Crespo-Leiro MG, Barge-Caballero E, Segovia-Cubero J, et al. Hyperkalemia in heart failure patients in Spain and its impact on guidelines and recommendations: ESC-EORP-HFA Heart Failure Long-Term Registry [published online October 28, 2019]. Rev Esp Cardiol (Engl Ed). doi: 10.1016/j.rec.2019.05.015