Association of Potassium Level at Discharge with Long-Term Mortality in Hospitalized Patients with Heart Failure

on behalf of the West Tokyo Heart Failure (WET-HF) Registry Investigators

Research output: Contribution to journalArticlepeer-review

Abstract

Dyskalemia (hypokalemia and hyperkalemia) is a common comorbidity of heart failure (HF). Although dyskalemia is associated with poor prognosis, different prognostic impacts of hypo- and hyperkalemia remain vastly unclear. This study investigated the association of dyskalemia with prognosis in HF patients, especially the mode of death and left ventricular ejection fraction (LVEF). The multicenter study included 3398 patients hospitalized for HF. Patients were divided into three groups based on serum potassium levels at discharge: hypokalemia (<3.5 mEq/L; n = 115 (3.4%)), normokalemia (3.5–5.0 mEq/L; n = 2960 (87.1%)), and hyperkalemia (≥5.0 mEq/L; n = 323 (9.5%)). Two-year all-cause, cardiac, and non-cardiac mortality was evaluated. Association of serum potassium with two-year mortality demonstrated a U-shaped curve, with a worse prognosis for patients with hypokalemia. All-cause mortality at two-years did not differ among the three groups. Hypokalemia was associated with 2-year cardiac death (adjusted hazard ratio (HR), 2.60; 95% confidence interval (CI), 1.20–5.64) in HF with reduced ejection fraction (HFrEF; LVEF < 40%), but not in non-HFrEF. Regardless of LVEF, hyperkalemia was not independently associated with any mortality. Hypokalemia was independently associated with cardiac death, particularly in HFrEF patients. Such an association was not observed in hyperkalemia regardless of LVEF.

Original languageEnglish
Article number7358
JournalJournal of Clinical Medicine
Volume11
Issue number24
DOIs
Publication statusPublished - 2022 Dec

Keywords

  • cardiac death
  • dyskalemia
  • heart failure
  • serum potassium
  • sudden death

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint

Dive into the research topics of 'Association of Potassium Level at Discharge with Long-Term Mortality in Hospitalized Patients with Heart Failure'. Together they form a unique fingerprint.

Cite this