Oral potassium supplement use and outcomes in chronic heart failure: a propensity-matched study.

Pubmed ID: 19135741

Pubmed Central ID: PMC2900187

Journal: International journal of cardiology

Publication Date: May 28, 2010

Affiliation: University of Alabama at Birmingham, Birmingham, AL 35294-2041, USA.

MeSH Terms: Humans, Male, Female, Middle Aged, Heart Failure, Hospitalization, Propensity Score, Disease Progression, Follow-Up Studies, Potassium, Hypokalemia, Dietary Supplements, Administration, Oral, Matched-Pair Analysis

Grants: R01 HL085561, R01 HL085561-02, 5-R01-HL085561-02, P50 HL077100

Authors: Ahmed MI, Ekundayo OJ, Love TE, Ahmed A, Sui X, Young JB, Perry GJ, Adamopoulos C, Bakris G, Pitt B, Fleg JL, Siscovick DS

Cite As: Ekundayo OJ, Adamopoulos C, Ahmed MI, Pitt B, Young JB, Fleg JL, Love TE, Sui X, Perry GJ, Siscovick DS, Bakris G, Ahmed A. Oral potassium supplement use and outcomes in chronic heart failure: a propensity-matched study. Int J Cardiol 2010 May 28;141(2):167-74. Epub 2009 Jan 9.

Studies:

Abstract

BACKGROUND: Hypokalemia is common in heart failure (HF) and is associated with increased mortality. Potassium supplements are commonly used to treat hypokalemia and maintain normokalemia. However, their long-term effects on outcomes in chronic HF are unknown. We used a public-use copy of the Digitalis Investigation Group (DIG) trial dataset to determine the associations of potassium supplement use with outcomes using a propensity-matched design. METHODS: Of the 7788 DIG participants with chronic HF, 2199 were using oral potassium supplements at baseline. We estimated propensity scores for potassium supplement use for each patient and used them to match 2131 pairs of patients receiving and not receiving potassium supplements. Matched Cox regression models were used to estimate associations of potassium supplement use with mortality and hospitalization during 40 months of median follow-up. RESULTS: All-cause mortality occurred in 818 (rate, 1327/10,000 person-years) and 802 (rate, 1313/10,000 person-years) patients respectively receiving and not receiving potassium supplements (hazard ratio {HR} when potassium supplement use was compared with nonuse, 1.05; 95% confidence interval {CI}, 0.94-1.18; P=0.390). All-cause hospitalizations occurred in 1516 (rate, 4777/10,000 person-years) and 1445 (rate, 4120/10,000 person-years) patients respectively receiving and not receiving potassium supplements (HR, 1.15; 95% CI, 1.05-1.26; P=0.004). HRs (95% CI) for hospitalizations due to cardiovascular causes and worsening HF were respectively 1.19 (95% CI, 1.08-1.32; P=0.001) and 1.27 (1.12-1.43; P<0.0001). CONCLUSION: The use of potassium supplements in chronic HF was not associated with mortality. However, their use was associated with increased hospitalization due to cardiovascular causes and progressive HF.