PMID- 22152974
OWN - NLM
STAT- MEDLINE
DCOM- 20120424
LR  - 20220317
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 109
IP  - 5
DP  - 2012 Mar 1
TI  - Frequency and predictors of hyperkalemia in patients >/=60 years of age with heart 
      failure undergoing intense medical therapy.
PG  - 693-8
LID - 10.1016/j.amjcard.2011.10.027 [doi]
AB  - Hyperkalemia is a concern in heart failure (HF), especially in older patients 
      with co-morbidities. Previous studies addressing this issue have focused mainly 
      on younger patients. This study was aimed at determining the frequency and 
      predictors of hyperkalemia in older patients with HF undergoing intense medical 
      therapy. Frequency and predictors of hyperkalemia were defined in patients (n = 
      566) participating in the Trial of Intensified versus Standard Medical Therapy in 
      Elderly Patients with Congestive Heart Failure, in which patients >/=60 years of 
      age were randomized to a standard versus an intensified N-terminal brain 
      natriuretic peptide-guided HF therapy. During an 18-month follow-up 76 patients 
      (13.4%) had hyperkalemia (>/=5.5 mmol/L) and 28 (4.9%) had severe hyperkalemia 
      (>/=6.0 mmol/L). Higher baseline serum potassium (odds ratio [OR] 2.92 per mmol/L), 
      baseline creatinine (OR 1.11 per 10 mumol/L), gout (OR 2.56), New York Heart 
      Association (NYHA) class (compared to NYHA class II, IV OR 3.08), higher dosage 
      of spironolactone at baseline (OR 1.20 per 12.5 mg/day), and higher dose changes 
      of spironolactone (compared to no dose change: 12.5 mg, OR 1.45; 25 mg, OR 2.52; 
      >25 mg, OR 3.24) were independent predictors for development of hyperkalemia (p 
      <0.05 for all comparisons). In conclusion, hyperkalemia is common in patients >/=60 
      years of age with HF undergoing intense medical therapy. Risk is increased in 
      patients treated with spironolactone, in addition to patient-specific risk 
      factors such as chronic kidney disease, higher serum potassium, advanced NYHA 
      class, and gout. Careful surveillance of serum potassium and cautious use of 
      spironolactone in patients at risk may help to decrease the incidence of 
      potentially hazardous complications caused by hyperkalemia.
CI  - Copyright A(c) 2012 Elsevier Inc. All rights reserved.
FAU - Muzzarelli, Stefano
AU  - Muzzarelli S
AD  - Department of Cardiology, University Hospital Basel, Switzerland. 
      stefano.muzzarelli@cardiocentro.org
FAU - Maeder, Micha Tobias
AU  - Maeder MT
FAU - Toggweiler, Stefan
AU  - Toggweiler S
FAU - Rickli, Hans
AU  - Rickli H
FAU - Nietlispach, Fabian
AU  - Nietlispach F
FAU - Julius, Barbara
AU  - Julius B
FAU - Burkard, Thilo
AU  - Burkard T
FAU - Pfisterer, Matthias Emil
AU  - Pfisterer ME
FAU - Brunner-La Rocca, Hans-Peter
AU  - Brunner-La Rocca HP
CN  - TIME-CHF Investigators
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20111205
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Biomarkers)
RN  - 0 (Diuretics)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 27O7W4T232 (Spironolactone)
RN  - RWP5GA015D (Potassium)
SB  - IM
MH  - Aged
MH  - Biomarkers/blood
MH  - Diuretics/*adverse effects/therapeutic use
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/blood/*drug therapy/mortality
MH  - Humans
MH  - Hyperkalemia/blood/chemically induced/*epidemiology
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/blood
MH  - Odds Ratio
MH  - Potassium/*blood
MH  - Predictive Value of Tests
MH  - Prevalence
MH  - Prognosis
MH  - Prospective Studies
MH  - Risk Factors
MH  - Spironolactone/*adverse effects/therapeutic use
MH  - Survival Rate/trends
MH  - Treatment Outcome
EDAT- 2011/12/14 06:00
MHDA- 2012/04/25 06:00
CRDT- 2011/12/14 06:00
PHST- 2011/09/22 00:00 [received]
PHST- 2011/10/25 00:00 [revised]
PHST- 2011/10/25 00:00 [accepted]
PHST- 2011/12/14 06:00 [entrez]
PHST- 2011/12/14 06:00 [pubmed]
PHST- 2012/04/25 06:00 [medline]
AID - S0002-9149(11)03201-2 [pii]
AID - 10.1016/j.amjcard.2011.10.027 [doi]
PST - ppublish
SO  - Am J Cardiol. 2012 Mar 1;109(5):693-8. doi: 10.1016/j.amjcard.2011.10.027. Epub 
      2011 Dec 5.