Elevated Admission Potassium Levels and 1-Year and 10-Year Mortality Among Patients With Heart Failure.

Abstract

BACKGROUND:

Limited, contradictory data exist regarding the effect of hyperkalemia on both short- and long-term all-cause mortality among hospitalized patients with heart failure (HF).

METHODS:

We analyzed 4,031 patients who were enrolled in the Heart Failure Survey in Israel. The study patients were grouped into 3 different potassium (K) categories. Multivariate analysis was used to determine the association of potassium levels as well as 1- and 10-year all-cause mortality.

RESULTS:

A total of 3,349 patients (83%) had K < 5mEq/L, whereas 461 patients (11%) had serum K ≥ 5mEq/L but≤ 5.5mEq/L and 221 patients (6%) had K > 5.5mEq/L. Survival analysis showed that 1-year mortality rates were significantly higher among patients with K > 5.5mEq/L (40%) and those with serum K ≥ 5mEq/L but ≤ 5.5mEq/L (34%) compared to those with K < 5mEq/L (27%); (all log rank P < 0.01). Similarly, 10-year mortality rates among those with K > 5.5mEq/L were 92%, whereas among those with serum K ≥ 5mEq/L but ≤ 5.5mEq/L rates were 88%, and in those with K < 5mEq/L rates were 82%; (all log rank P < 0.001). Consistently, multivariate analysis showed that compared to patients with K < 5mEq/L, patients with K > 5.5mEq/L had an independently 51% and 31% higher mortality risk at 1 year and 10 years, respectively (1-year hazard ratio = 1.51, 95% CI: 1.04-2.2; 10-years hazard ratio = 1.31, 95% CI: 1.035-1.66), whereas patients with serum K ≥ 5mEq/L but ≤ 5.5mEq/L had comparable adjusted mortality risk to patients with K < 5mEq/L at 1 and 10 years.

CONCLUSIONS:

Among hospitalized patients with HF, admission K > 5.5mEq/L was independently associated with increased short- and long-term mortality, whereas serum K ≥ 5mEq/L but ≤ 5.5mEq/L was not independently associated with worse outcomes.

• Authors: Anan Younis, Ilan Goldenberg, Ronen Goldkorn, Arwa Younis, Yael Peled, Boaz Tzur, Robert Klempfner
• Journal: The American journal of the medical sciences (Am J Med Sci) Vol. 354 Issue 3 Pg. 268-277 (09 2017) ISSN: 1538-2990 [Electronic] United States
• PMID: 28918834 (Publication Type: Journal Article)
• Copyright: Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Chemical References

• Potassium

Topics

• Aged
• Cause of Death (trends)
• Cohort Studies
• Echocardiography
• Female
• Heart Failure (blood, diagnostic imaging, mortality)
• Humans
• Hyperkalemia (blood)
• Israel (epidemiology)
• Male
• Multivariate Analysis
• Patient Admission
• Potassium (blood)
• Proportional Hazards Models
• Prospective Studies
• Time Factors