Hiperpotassemia na vigência de espironolactona em pacientes com insuficiência cardíaca descompensada

Lima, Marcelo; Ochiai, Marcelo Eidi; Cardoso, Juliano; Morgado, Paulo; Munhoz, Robinson Tadeu; Barretto, Antônio Carlos Pereira

doi:10.1590/s0066-782x2008001500009

Cited by 1 publication

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References 17 publications

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“…Several studies have reported increased hyperkalemia trends associated with widespread adoption of medications including angiotensin converting enzyme inhibitors 16 , aldosterone receptor blockers 17 , spironolactone 7,18 . Our study extends prior work by describing mortality according to varying degrees of hyperkalemia, as well as examining outcomes stratified by the number of hyperkalemia values and normalization (versus persistence) of hyperkalemia.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Prognosis of Hyperkalemia in Patients with Acute Myocardial Infarction

Grodzinsky

Goyal

Gosch

et al. 2016

The American Journal of Medicine

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Background Hyperkalemia is common and potentially dangerous in hospitalized patients; its contemporary prevalence and prognostic importance following acute myocardial infarction are not well described. Methods In 38,689 consecutive acute myocardial infarction patients from the Cerner Health Facts database, we evaluated the association between maximum in-hospital potassium levels (max K) and in-hospital mortality. Patients were stratified by dialysis status, and grouped by max K as follows: <5 mEq/L, 5–<5.5 mEq/L, 5.5–<6.0 mEq/L, 6.0–<6.5 mEq/L, and ≥ 6.5 mEq/L. Multivariable logistic regression was used to adjust for multiple patient and site characteristics. The relationship between number of hyperkalemic values and in-hospital mortality was also evaluated. Results Of 38,689 acute myocardial infarction patients, 886 were on dialysis. The rate of hyperkalemia (max K ≥ 5.0 mEq/L) was 22.6% in non-dialysis and 66.8% in dialysis patients. Moderate-severe hyperkalemia (max K ≥ 5.5 mEq/L) occurred in 9.8% of patients. There was a steep increase in mortality with higher max K levels. In-hospital mortality exceeded 15% once max K ≥5.5 mEq/L regardless of dialysis status. The relationship between higher max K and increased mortality risk persisted after multivariable adjustment. In addition, patients with greater number of hyperkalemic values (vs. a single value) experienced higher in-hospital mortality. Conclusions Hyperkalemia is common in patients hospitalized with acute myocardial infarction. Higher max K levels and number of hyperkalemic events are associated with a steep mortality increase; with higher risks for adverse outcomes observed even at mild levels of hyperkalemia. Whether more intensive management of hyperkalemia may improve outcomes in acute myocardial infarction patients merits further study.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Prognosis of Hyperkalemia in Patients with Acute Myocardial Infarction

Grodzinsky

Goyal

Gosch

et al. 2016

The American Journal of Medicine

View full text Add to dashboard Cite

show abstract

Hiperpotassemia na vigência de espironolactona em pacientes com insuficiência cardíaca descompensada

Abstract: SummaryBackground: The incidence of hyperkalemia related to spironolactone use is low in stable heart failure; however, it has not been studied during decompensation.

Cited by 1 publication

References 17 publications

Prevalence and Prognosis of Hyperkalemia in Patients with Acute Myocardial Infarction

Prevalence and Prognosis of Hyperkalemia in Patients with Acute Myocardial Infarction

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