Table 3.
HRs for Clinical Outcomes 6 Months After Hyperkalemia Versus Fully Matched Comparisons Without Hyperkalemia
| Outcome | Patients With HF With First Hyperkalemia >5.0 mmol/L | Matched HF Comparisons Without Hyperkalemiaa | Fully Adjusted HR (95% CI)b | Prior Event Rate Ratio Adjusted HR (95% CI)c |
|---|---|---|---|---|
| n (Rate per 1000 Person‐Years) | n (Rate per 1000 Person‐Years) | |||
| Any hospital outpatient contact | 7760 (3204.49) | 6444 (1717.40) | 1.64 (1.58–1.70) | 1.39 (1.34–1.46) |
| Any acute‐care hospitalization | 9100 (4499.29) | 5101 (1261.17) | 2.75 (2.65–2.85) | 2.26 (2.17–2.35) |
| Any non–acute‐care hospitalization | 2786 (778.41) | 1913 (381.40) | 1.93 (1.81–2.06) | 1.65 (1.53–1.78) |
| Any cardiac diagnosis | 7492 (3017.17) | 4198 (980.49) | 2.47 (2.37–2.58) | 2.19 (2.09–2.29) |
| Ventricular arrhythmia | 450 (104.85) | 230 (41.67) | 2.27 (1.91–2.69) | 2.33 (1.88–2.88) |
| Cardiac arrest | 156 (35.42) | 41 (7.35) | 5.34 (3.70–7.73) | 7.30 (3.55–16.01) |
| Dialysis procedure | 223 (51.06) | 61 (10.95) | 1.75 (1.30–2.35) | 1.18 (0.85–1.60) |
| Ventilator treatment | 990 (233.90) | 185 (33.38) | 6.80 (5.77–8.02) | 4.46 (3.29–5.86) |
| ICU admission | 1837 (460.02) | 459 (83.93) | 5.12 (4.60–5.71) | 4.42 (3.80–5.29) |
| HF readmission | 5309 (1718.65) | 3147 (692.21) | 2.15 (2.05–2.26) | 1.96 (1.88–2.05) |
| ACEi prescription | 4430 (1572.70) | 4863 (1311.79) | 1.05 (1.01–1.10) | 0.99 (0.95–1.02) |
| ARB prescription | 1223 (305.03) | 1406 (276.36) | 1.00 (0.92–1.09) | 1.03 (0.97–1.09) |
| Spironolactone prescription | 3182 (943.22) | 2876 (625.89) | 1.07 (1.02–1.13) | 0.84 (0.81–0.88) |
| Potassium supplement prescription | 4109 (1326.70) | 5919 (1713.53) | 0.81 (0.78–0.84) | 0.75 (0.72–0.78) |
| Death | 4457 (1006.59) | 1542 (276.03) | 3.39 (3.19–3.61) | – |
ACEi indicates angiotensin‐converting enzyme inhibitor; ARB, angiotensin receptor II blocker; CI, confidence interval; HF, heart failure; HR, hazard ratio; ICU, intensive care unit.
HF comparisons without hyperkalemia individually matched to patients with HF with hyperkalemia on age, sex, and HF duration (see Statistical Analysis section).
Adjusted for age, sex, and HF duration by matched design and, by Cox regression analyses, for HF treatment regimen, number of acute HF hospitalizations 6 months before the hyperkalemia/index date, estimated glomerular filtration rate category, Charlson Comorbidity Index score, presence of diabetes mellitus/chronic kidney disease/hypertension, use of ACEis/ARBs, spironolactone, or potassium supplements.
The prior event rate ratio adjusted HR is the ratio of the 2 age, sex, and HF duration matched rate ratios observed 6 months after vs 6 months before the hyperkalemia/index date. (see Additional and Sensitivity Analyses section).