Raw data of the publication: Does moderate hyperkalemia influence survival in HF? Insights from the MECKI score data (Int J Cardiol . 2023 Jan 15;371:273-277. doi: 10.1016/j.ijcard.2022.09.030. Epub 2022 Sep 15)

Background: The prognostic role of moderate hyperkalemia in reduced ejection fraction (HFrEF) patients is still controversial. Despite this, it affects the use of renin-angiotensin-aldosterone system inhibitors (RAASi) with therapy down-titration or discontinuation.

Objectives: Aim of the study was to assess the prognostic impact of moderate hyperkalemia in chronic HFrEF optimally treated patients.

Methods and results: We retrospectively analyzed MECKI (Metabolic Exercise test data combined with Cardiac and Kidney Indexes) database, with median follow-up of 4.2 [IQR 1.9-7.5] years. Data on K+ levels were available in 7087 cases. Patients with K+ plasma level ≥ 5.6 mEq/L and < 4 mEq/L were excluded. Remaining patients were categorized into normal >4 and < 5 mEq/L (n = 4826, 68%) and moderately high ≥5.0 and ≤ 5.5 mEq/L (n = 496, 7%) K+. Then patients were matched by propensity score in 484 couplets of patients. MECKI score value was 7% [IQR 3.1-14.1%] and 7.3% [IQR 3.4-15%] (p = 0.678) in patients with normal and moderately high K+ values while cardiovascular mortality events at two years follow-up were 41 (4.2%) and 33 (3.4%) (p = 0.333) in each group respectively.

Conclusions: Moderate hyperkalemia does not influence patients' outcome in a large cohort of ambulatory HFrEF patients.

背景：中度高钾血症在射血分数降低型心力衰竭（HFrEF）患者中的预后价值仍存在争议。尽管如此，该指标仍会影响肾素-血管紧张素-醛固酮系统抑制剂（RAASi）的临床应用，常导致治疗剂量下调或直接停药。

研究目标：本研究旨在评估中度高钾血症在接受优化治疗的慢性射血分数降低型心力衰竭患者中的预后影响。

方法与结果：本研究回顾性分析了MECKI（代谢运动试验数据联合心脏与肾脏指标）数据库，患者的中位随访时间为4.2年[四分位距1.9~7.5年]。共计7087例患者拥有血清钾离子水平数据。研究排除了血浆钾离子浓度≥5.6 mEq/L及<4 mEq/L的患者。剩余患者被分为两组：血钾正常组（血浆钾离子浓度>4且<5 mEq/L，n=4826，占比68%）及中度高钾血症组（血浆钾离子浓度≥5.0且≤5.5 mEq/L，n=496，占比7%）。随后通过倾向得分匹配法对两组患者进行配对，最终得到484对匹配病例。正常血钾组与中度高钾血症组患者的MECKI评分分别为7%[四分位距3.1~14.1%]与7.3%[四分位距3.4~15%]（p=0.678）；两组患者随访2年时的心血管死亡事件分别为41例（4.2%）与33例（3.4%）（p=0.333）。

结论：中度高钾血症不会对大型门诊射血分数降低型心力衰竭患者队列的临床结局产生影响。