Author + information
- Bertram Pitta,b,
- Coleman Grossa,b,
- Martha Mayoa,b,
- Dahlia Garzaa,b,
- Jinwei Yuana,b,
- Daniel Wilsona,b and
- Matthew Weira,b
Background: Aldosterone (ALD) plays an important role in the progression of HF and may be increased in HF due to activation of the renin-angiotensin-aldosterone system (RAAS). Hyperkalemia (HK) may also increase ALD and limits the use of RAAS inhibitors (RAASi). Patiromer, a nonabsorbed K+ binder, reduced serum K+ (sK+) and ALD in a phase 3 study of pts with HK and CKD on RAASi (OPAL-HK). In this post-hoc analysis, we examined changes in sK+ and ALD in the subgroup with HF during the 4-wk treatment phase of OPAL-HK.
Methods: Mean change from baseline to wk 4 in sK+ and ALD were analyzed in 102 pts with NYHA classes I-III HF and in 141 pts without HF. Patiromer starting doses were 8.4 g/day for pts with mild HK (sK+ 5.1-<5.5 mEq/L) and 16.8 g/day for pts with moderate-severe HK (sK+ ≥5.5 mEq/L), divided twice daily.
Results: Baseline ALD was higher in pts with HF than without HF (Table). In pts with mild HK, small or nonsignificant changes in ALD were observed with modest sK+ reductions, regardless of HF status. In pts with moderate-severe HK, significant decreases in ALD, which were greater in the HF subgroup, were observed with larger sK+ reductions.
Conclusions: HF patients with moderate-severe HK experienced the most improvement in ALD level with patiromer treatment. sK+ may play an important role in modulating ALD in HF.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Heart Failure and Cardiomyopathies: Heart Failure Is Just a Revolving Door
Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy
Presentation Number: 1293-245
- 2017 American College of Cardiology Foundation