ArticleHeart and vessels2026
Comparative effectiveness of sodium zirconium cyclosilicate versus calcium polystyrene sulfonate for patients with heart failure.
Article in Heart and vessels, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Patients with heart failure (HF) are at increased risk of hyperkalemia, and implementing appropriate potassium-lowering therapy is essential for optimizing outcomes. Sodium zirconium cyclosilicate (SZC) is a selective potassium binder that effectively reduces serum potassium levels; however, its impact on mortality and cardiovascular outcomes in HF remains unclear. This study compared the effects of SZC and calcium polystyrene sulfonate (CPS) on a composite of all-cause death and major adverse cardiovascular event (MACE)-related hospitalization, along with individual MACE components and continuation rates of HF medications. We conducted a retrospective cohort study using data from the JMDC hospital database, including adult patients with HF who initiated SZC or CPS between April 2020 and September 2023 and continued treatment for at least 30 days. Propensity score-based inverse probability of treatment weighting (IPTW) and multivariable Cox models were used to control for confounding. A total of 12,918 patients were included (11,139 CPS; 1779 SZC), with a median follow-up of 147 and 138 days, respectively. After IPTW adjustment, baseline characteristics were balanced, except for the prescription year. The primary composite outcome (all-cause death or MACE hospitalization) occurred in 148 patients in the SZC group and 839 in the CPS group (Hazard ratio [HR] 1.16, 95% confidence interval [CI] 0.94-1.43). In a post hoc analysis, the composite of all-cause death and HF hospitalization occurred in 143 vs. 793 patients (HR 1.21, 95% CI 0.98-1.50). SZC use was associated with a higher HR for HF hospitalization (103 vs. 524 events, HR 1.36, 95% CI 1.06-1.75) and a lower HR for stroke hospitalization (6 vs. 80 events, HR 0.33, 95% CI 0.12-0.91). Mineralocorticoid receptor antagonists (MRA) continuation was more frequent in the SZC group [70.1% vs. 59.0%, weighted odds ratio, 1.39 (95% CI 1.11-1.75)]. These findings suggest that although SZC may not improve survival or overall cardiovascular outcomes, it may help maintain essential HF therapies such as MRA.
Indexed as
Identifiers
41055706What OpenQuestion holds
Registered trials
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.