Skip to Main content Skip to Navigation
Journal articles

Serum Potassium in the PARADIGM-HF trial

Abstract : Background: We studied the association between potassium and outcomes, the effect of sacubitril/valsartan on potassium, and whether potassium level modified the effect of sacubitril/valsartan in patients with heart failure and a reduced ejection fraction in PARADIGM-HF. Aims: We examined several outcomes including cardiovascular death, sudden-death, pump-failure death, non-cardiovascular death and heart failure hospitalization. Methods: 8399 patients were randomized to either enalapril or sacubitril/valsartan. Potassium at randomization and follow-up was examined as a continuous and categorical variable (≤3.5, 3.6-4.0, 4.1-4.9, 5.0-5.4, and ≥5.5mmol/L) in various statistical models. Hyperkalemia was defined as K+ ≥5.5mmol/L and hypokalemia as K+ ≤3.5mmol/L. Results: Compared to potassium 4.1-4.9mmol/L, both hypokalemia (HR 2.40, 95%CI 1.84-3.14) and hyperkalemia (HR 1.42, 1.10-1.83) were associated with a higher risk of cardiovascular death. However, potassium abnormalities were similarly associated with sudden death and pump failure death, as well as non-cardiovascular death and heart failure hospitalization. Sacubitril/valsartan had no effect on potassium overall. The benefit of sacubitril/valsartan over enalapril was consistent across the range of baseline potassium. Conclusions: Although both higher and lower potassium were independent predictors of cardiovascular death, potassium abnormalities may mainly be markers rather than mediators of risk of death.
Complete list of metadatas

Cited literature [52 references]  Display  Hide  Download

https://hal.univ-lorraine.fr/hal-02918319
Contributor : Erwan Bozec <>
Submitted on : Thursday, August 20, 2020 - 12:46:22 PM
Last modification on : Thursday, January 7, 2021 - 4:00:03 PM
Long-term archiving on: : Tuesday, December 1, 2020 - 2:08:00 AM

Files

 Restricted access
To satisfy the distribution rights of the publisher, the document is embargoed until : 2021-02-19

Please log in to resquest access to the document

Identifiers

Collections

Citation

Joao Pedro Ferreira, Ulrik Mogensen, Pardeep Jhund, Akshay Desai, Jean-Lucien Rouleau, et al.. Serum Potassium in the PARADIGM-HF trial. European Journal of Heart Failure, Oxford University Press (OUP), 2020, ⟨10.1002/ejhf.1987⟩. ⟨hal-02918319⟩

Share

Metrics

Record views

46