Acute heart failure and adverse events associated with the presence of renal dysfunction and hyperkalaemia. EAHFE- renal dysfunction and hyperkalaemia

Jacob, Javier; Llauger, Lluis; Herrero-Puente, Pablo; Martín-Sánchez, Francisco J.; Llorens, Pere; Roset, Alex; Gil, Víctor; Fuentes, Marta; Lucas-Imbernón, Francisco Javier; Miró, Òscar; ICA-SEMES Research Group

doi:http://dx.doi.org/10.1016/j.ejim.2019.07.010

Acute heart failure and adverse events associated with the presence of renal dysfunction and hyperkalaemia. EAHFE- renal dysfunction and hyperkalaemia

Citation

Jacob J, Llauger L, Herrero-Puente P, Martín-Sánchez FJ, Llorens P, Roset A, et al. Acute heart failure and adverse events associated with the presence of renal dysfunction and hyperkalaemia. EAHFE- renal dysfunction and hyperkalaemia. Eur J Intern Med. 2019 Sep;67:89-96. DOI 10.1016/j.ejim.2019.07.010

Abstract

Objective: To study the outcomes of patients with acute heart failure (AHF) presenting renal dysfunction (RD) or hyperkalaemia (Hk) alone or in combination. Method: We analysed the data of the EAHFE registry, a multicentre, non interventionist cohort with prospective follow-up of patients with AHF. Four groups were defined based on the presence or not of RD or Hk alone or in combination. The primary endpoint was 30-day all-cause mortality. Results: A total of 11,935 of the 13,791 patients included in the EAHFE registry were analysed. Of these, 5088 (42.6%) did not have RD or Hk (NoRD-NoHk), 150 (1.3%) had no RD but had Hk (NoRD-Hk), 6012 (50.4%) had RD but not Hk (RD-NoHk) and 685 (5.7%) had both RD and Hk (RD-Hk). Thirty-day all-cause mortality was greatest in the RD-Hk group with an adjusted Hazard Ratio (HR) of 2.44 (confidence interval 95% [CI95%] 1.67-3.55; p < 0.001) and in the RD-NoHk group with an adjusted HR of 1.34 (CI95% 1.04-1.71; p = 0.022). There were no significant differences in in-hospital mortality and reconsultation at 30 days for HF. For the combined endpoint of 30-day all-cause mortality the adjusted HR was 1.33 (CI95% 1.04-1.70); (p = 0.021) for the RD-Hk group. Conclusions: The association of 30-day all-cause mortality with the presence of RD and Hk in patients presenting AHF at admission is greater than in those without this combination.