Evidence map›Paper›PMID 36738129›Full record

ArticleESC heart failure2023

Serum potassium level and mineralocorticoid receptor antagonist dose in a large cohort of chronic heart failure patients.

Pascal R D Clephas, Sumant P Radhoe, Gerard C M Linssen, Jorina Langerveld, Jacobus Plomp, Jeroen P P Smits, Michiel J Nagelsmit, Hans-Peter Brunner-La Rocca, Jasper J Brugts

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PubMed Full text at PMC Publisher
In one paragraph

Article in ESC heart failure, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 2 countries.

Pascal R D ClephasDepartment of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.ORCID 0000-0001-9752-6962
Sumant P RadhoeDepartment of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Gerard C M LinssenDepartment of Cardiology, Hospital Group Twente, Hengelo, The Netherlands.
Jorina LangerveldDepartment of Cardiology, Hospital Rivierenland, Tiel, The Netherlands.
Jacobus PlompDepartment of Cardiology, Tergooi, Blaricum, The Netherlands.
Jeroen P P SmitsDepartment of Cardiology, Zuwe Hofpoort Hospital, Woerden, The Netherlands.
Michiel J NagelsmitDepartment of Cardiology, Scheper Hospital, Emmen, The Netherlands.
Hans-Peter Brunner-La RoccaDepartment of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands.
Jasper J BrugtsDepartment of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Erasmus MC · NLEuropean Organisation for Research and Treatment of Cancer · NLTergooi · NLTreant Zorggroep · NLUniversity Medical Center · USZiekenhuis Groep Twente · NLZiekenhuis Rivierenland · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsHyperkalaemia is observed frequently in heart failure (HF) patients and is associated with an impaired prognosis and underuse of mineralocorticoid receptor antagonists (MRAs). However, the effects of serum potassium on prescription of the full guideline recommended daily dose of 50 mg in real-world daily practice are unknown. Therefore, we investigated serum potassium and its association with the prescribed MRA dose in a large cohort of chronic HF patients. METHODS AND

resultsA total of 5346 patients with chronic HF with a left ventricular ejection fraction ≤40% from 34 Dutch outpatient HF clinics between 2013 and 2016 were analysed on serum potassium and MRA (spironolactone and eplenerone) dose. Data were stratified by potassium as a serum potassium level <4.0, 4.0 to 5.0 or >5.0 mmol/L. Multivariable logistic regression models were used to assess the association between serum potassium and MRA dose and to adjust for potential confounders. Mean serum potassium was 4.4 ± 0.5 mmol/L and hyperkalaemia (serum potassium >5.0 mmol/L) was present in 399 patients (7.5%). MRA was used in 3091 patients (58.1%). Patients with hyperkalaemia significantly less often received ≥100% of the target dose (50 mg) compared with patients with a serum potassium between 4.0-5.0 mmol/L and <4.0 mmol/L (7.7% vs. 9.5% vs. 13.6% respectively, P = 0.0078). In the multivariable regression analyses, patients with hyperkalaemia were significantly less likely to receive ≥100% of the target dose compared with patients with serum potassium 4.0-5.0 mmol/L (OR 0.38, 95% CI 0.15-0.97, P = 0.044). Additionally, a one unit increase in serum potassium was significantly associated with a lower odds of receiving ≥100% of the target dose (OR 0.69, 95% CI 0.49-0.98, P = 0.036).

conclusionsIn this large registry of real-world chronic HF patients, both an increase in serum potassium and hyperkalaemia were associated with a lower odds of receiving the guideline-recommended MRA dose.

Indexed as

Heart FailureHyperkalemiaChronic DiseaseHumansMineralocorticoid Receptor AntagonistsPotassiumStroke VolumeVentricular Function, LeftMineralocorticoid Receptor AntagonistsPotassiumGuidelinesHeart failureHeart failure with reduced ejection fractionHyperkalaemiaMineralocorticoid receptor antagonistsRenin-angiotensin-aldosterone system inhibitors

Identifiers

PMID36738129
PMCPMC10053159
OpenAlexW4319216428

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.