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Hyper-Kalaemia as cause for discontinuation of RAASi in patients with heart failure

Session Poster Session 1

Speaker Giuseppe M C Rosano

Event : Heart Failure 2016

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure
  • Session type : Poster Session

Authors : G M C Rosano (Rome,IT), G Marazzi (Rome,IT), G Caminiti (Rome,IT), G Campolongo (Rome,IT), M Volterrani (Rome,IT)

G M C Rosano1 , G Marazzi1 , G Caminiti1 , G Campolongo1 , M Volterrani1 , 1San Raffaele Pisana Hospital IRCCS - Rome - Italy ,

European Journal of Heart Failure Abstracts Supplement ( 2016 ) 18 ( Supplement 1 ), 109

ACE inhibitors and Aldosterone antagonists (or mineralocorticoid receptor antagonists [MRAs]) are guideline-recommended therapy for patients with heart failure reduced left ventricular ejection fraction (HFrEF), and in postmyocardial infarction patients with HF. Often the use of drugs acting on the renin angiotensin aldosterone system (RAASi) cannot be fully implemented because of the occurrence of hyperkalaemia. Aim of the present study was to assess the occurrence of hyperkalaemia and the need for discontinuation of RAASi therapy because of high K levels in patients with chronic heart failure attending a tertiary health care centre over a period of 5 years. Amongst 968 patients with full available data 402 had to discontinue at least one RAASi because of hyperkalaemia. Hyperkalaemia was mild in 45% of patients discontinuing RAASi and moderate-severe in 55%. Discontinuation of RAASi therapy was more frequent in patients with preserved or in those with severely impaired renal function while no correlation was found with NYHA class or LVEF. In conclusion hyperkalaemia is a frequent occurrence in patients with heart failure, limits the implementation of life-saving medications. This may well translate into a negative prognostic effect.

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