Mild hyperkalemia and outcomes in chronic heart failure: A propensity matched study
Mild hyperkalemia and outcomes in chronic heart failure: A propensity matched study
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DOI：
10.1016/j.ijcard.2009.04.041
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发表时间：
2010-10-29
影响因子：
3.5
通讯作者：
Ahmed, Ali
中科院分区：
文献类型：
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作者：
Ahmed, Mustafa I.;Ekundayo, O. James;Ahmed, Ali
背景：与血清钾水平4 ~ 5.5mEq/L相比，5.5mEq/L可能对HF有害。然而，对血清钾5-5.5 mEq/L的安全性了解甚少。方法：在毛地黄研究组试验的7788例慢性HF患者中，5656例血清钾为4-5.5 mEq/L。其中567例为轻度高钾血症（5-5.5 mEq/L）， 5089例为正钾血症（4-4.9 mEq/L）。使用轻度高钾血症的倾向评分来组合548例轻度高钾血症患者和1629例正常血钾血症患者的平衡队列。在中位随访38个月期间，使用Cox回归模型估计轻度高钾血症与死亡率之间关联的风险比（HR）和95%置信区间（CI）。结果：正常血钾和轻度高血钾匹配患者的全因死亡率分别为36%和38% （HR, 1.07; 95% CI, 0.90-1.26； P=0.458）。与轻度高钾血症相关的死亡率未经调整、多变量调整和倾向调整的hr为1.33 (95% CI, 1.15-1.52； P
Background: Compared with serumpotassiumlevels 4-5.5mEq/L, those 5.5 mEq/L may be harmful in HF. However, little is known about the safety of serum potassium 5-5.5 mEq/L.Methods: Of the 7788 chronic HF patients in the Digitalis Investigation Group trial, 5656 had serum potassium 4-5.5 mEq/L. Of these, 567 had mild hyperkalemia (5-5.5 mEq/L) and 5089 had normokalemia (4-4.9 mEq/L). Propensity scores for mild hyperkalemia were used to assemble a balanced cohort of 548 patients with mild hyperkalemia and 1629 patients with normokalemia. Cox regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for association between mild hyperkalemia and mortality during a median follow-up of 38 months.Results: All-cause mortality occurred in 36% and 38% of matched patients with normokalemia and mild hyperkalemia respectively (HR, 1.07; 95% CI, 0.90-1.26; P=0.458). Unadjusted, multivariable-adjusted, and propensity-adjusted HRs for mortality associated with mild hyperkalemia were 1.33 (95% CI, 1.15-1.52; P