Abstract | BACKGROUND: METHODS: RESULTS: A total number of 16,065 patients from 7 trials were analyzed. Hyperkalemia was more frequently observed on MRA (9.3%) vs placebo (4.3%) (risk ratio 2.17, 95% CI 1.92-2.45, P<.0001). Truly MRA-related hyperkalemia was 54%, whereas 46% were non-MRA related. In trials using eplerenone, hyperkalemia was documented in 5.0% on eplerenone and in 2.6% on placebo (P<.0001). In spironolactone trials, hyperkalemia was documented in 17.5% and in 7.5% of patients on placebo (P=.0001). Hypokalemia occurred less frequently in patients on MRA (9.3%) compared with placebo (14.8%) (risk ratio 0.58, CI 0.47-0.72, P<.0001). CONCLUSION: This meta-analysis shows that in clinical trials, 54% of hyperkalemia cases were specifically related to the MRA treatment and 46% to other reasons. Therefore, non-MRA-related rises in potassium levels might be underestimated and should be rigorously explored before cessation of the evidence-based therapy with MRAs.
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Authors | Davor Vukadinović, Daniel Lavall, Aleksandra Nikolovska Vukadinović, Bertram Pitt, Stefan Wagenpfeil, Michael Böhm |
Journal | American heart journal
(Am Heart J)
Vol. 188
Pg. 99-108
(Jun 2017)
ISSN: 1097-6744 [Electronic] United States |
PMID | 28577687
(Publication Type: Journal Article, Meta-Analysis, Review)
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Copyright | Copyright © 2017 Elsevier Inc. All rights reserved. |
Chemical References |
- Mineralocorticoid Receptor Antagonists
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Topics |
- Controlled Clinical Trials as Topic
- Global Health
- Heart Failure
(drug therapy)
- Humans
- Hyperkalemia
(chemically induced, epidemiology)
- Incidence
- Mineralocorticoid Receptor Antagonists
(adverse effects, therapeutic use)
- Risk Factors
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