Serum potassium dynamics during acute heart failure hospitalization

Area of Science:

• Cardiology
• Internal Medicine
• Clinical Research

Background:

• Prognostic implications of potassium level alterations in acute heart failure (AHF) are not well-established.
• Dyskalemia (hypokalemia or hyperkalemia) is a frequent complication in AHF patients.

Purpose of the Study:

• To determine the prevalence and dynamic changes of dyskalemia during AHF hospitalization.
• To investigate the long-term clinical impact of dyskalemia after AHF hospitalization.

Main Methods:

• Analysis of 1779 patients hospitalized with AHF from the REDINSCOR II registry.
• Classification of patients into hypokalemia, normokalemia, and hyperkalemia groups based on admission and discharge potassium levels.

Main Results:

• Prevalence of hypokalemia and hyperkalemia on admission was 8.2% and 4.6%, respectively; at discharge, it was 6.4% and 2.7%.
• Hyperkalemia on admission independently predicted higher in-hospital mortality (OR=2.32).
• Dyskalemia independently predicted higher 12-month mortality (HR=1.48), with persistent hypokalemia (HR=3.17) and transient hyperkalemia (HR=1.75) significantly reducing survival.

Conclusions:

• Potassium level alterations are frequent and dynamic during AHF admission.
• Hyperkalemia on admission is an independent predictor of increased in-hospital mortality.
• Persistent hypokalemia and transient hyperkalemia are independent predictors of 12-month mortality in AHF patients.