This article is more than 5 years old. Information may no longer be current.
Empiric potassium supplementation, loop diuretics may increase survival
Click Here to Manage Email Alerts
Potassium supplementation upon initiation of loop diuretic therapy was associated with improved survival rates, with greater benefit observed with higher diuretic doses, in patients with HF, according to results from a retrospective cohort study.
Researchers examined the association between empiric potassium supplementation and adverse clinical outcomes in patients with HF who were new initiators of loop diuretic therapy. The propensity score-matched cohort study used Medicare claims from five states from 1999 to 2007. The researchers identified 654,060 patients with HF who initiated loop diuretic therapy; 27% received empiric potassium supplementation, defined as a potassium prescription on the day of or day after the initial prescription for loop diuretics, and 73% did not.
The primary outcome was all-cause mortality, verified by records from the Social Security Administration Death Master File. The secondary outcome was outpatient-originating sudden cardiac death or ventricular arrhythmia.
Patients who received empiric potassium supplementation were more likely to survive during the study period compared with those who received no potassium (HR=0.93; 95% CI, 0.89-0.98).
The 96% of patients with a loop diuretic prescription for furosemide were stratified by initial dose of <40 mg/day or ≥40 mg/day. In that population, the impact of potassium supplementation on survival was greater in patients who were taking a larger dose of furosemide (<40 mg/day group, HR=0.93; 95% CI, 0.86-1; ≥40 mg/day group, HR=0.84; 95% CI, 0.79-0.89), the researchers found.
Empiric potassium supplementation had no effect on outpatient-originating sudden cardiac death or ventricular arrhythmia (HR=1.02; 95% CI, 0.83-1.24).
“Our findings indicate that adding potassium supplementation may increase survival rates among patients taking loop diuretics,” Charles E. Leonard, PharmD, MSCE, senior research investigator at the University of Pennsylvania Center for Clinical Epidemiology and Biostatistics and senior manager of the Ambulatory Drug Use and Effects Program at Penn, said in a press release. “Nonetheless, because this is the first such study of this question, we hope that others confirm these results in independent studies.”
Disclosure: The study was funded by the NIH. Two researchers report financial ties with Amgen, AstraZeneca, Bristol-Myers Squibb, CSL Behring and Millennium.
Click Here to Manage Email Alerts