Patiromer Facilitates Angiotensin Inhibitor and Mineralocorticoid Antagonist Therapies in Patients With Heart Failure and Hyperkalemia

被引：2

作者：

Pitt, Bertram ^{[1
]}

Anker, Stefan D. ^{[2
]}

Lund, Lars H. ^{[3
,4
]}

Coats, Andrew J. S. ^{[5
]}

Filippatos, Gerasimos ^{[6
]}

Rossignol, Patrick ^{[7
,8
,9
,10
,11
]}

Weir, Matthew R. ^{[12
]}

Friede, Tim ^{[13
,14
]}

Kosiborod, Mikhail N. ^{[15
,16
]}

Metra, Marco ^{[17
,18
]}

Boehm, Michael ^{[19
]}

Ezekowitz, Justin A. ^{[20
]}

Bayes-Genis, Antoni ^{[21
,22
]}

Mentz, Robert J. ^{[23
]}

Ponikowski, Piotr ^{[24
]}

Senni, Michele ^{[25
]}

Pina, Ileana L. ^{[26
]}

Pinto, Fausto J. ^{[27
]}

van der Meer, Peter ^{[28
]}

Bahit, Cecilia ^{[29
]}

Belohlavek, Jan ^{[30
]}

Brugts, Jasper J. ^{[31
]}

Perrin, Amandine ^{[32
]}

Waechter, Sandra ^{[32
]}

Budden, Jeffrey ^{[33
]}

Butler, Javed ^{[34
]}

机构：

[1] Univ Michigan, Dept Cardiol, 1301 Catherine St, Ann Arbor, MI 48109 USA

[2] Charite, Inst Hlth Ctr Regenerat Therapies BCRT, Dept Cardiol CVK German Heart Ctr Charite, German Ctr Cardiovasc Res DZHK,Partner Site Berli, Berlin, Germany

[3] Karolinska Inst, Dept Med, Unit Cardiol, Solna, Sweden

[4] Karolinska Univ Hosp, Dept Cardiol, Stockholm, Sweden

[5] Heart Res Inst, Sydney, NSW, Australia

[6] Natl & Kapodistrian Univ Athens, Sch Med, Athens Univ Hosp Attikon, Athens, Greece

[7] Princess Grace Hosp, Med Specialties Dept, Fontvieille, Monaco

[8] Princess Grace Hosp, Dept Nephrol, Fontvieille, Monaco

[9] Monaco Private Hemodialysis Ctr, Fontvieille, Monaco

[10] Univ Lorraine, CHRU, Ctr Invest Clin Plurithemat 14 33, INSERM,U1116, Nancy, France

[11] F CRIN INI CRCT Cardiovasc & Renal Clin Trialists, Nancy, France

[12] Univ Maryland, Sch Med, Dept Med, Div Nephrol, Baltimore, MD USA

[13] Univ Med Ctr Gottingen, Dept Med Stat, Gottingen, Germany

[14] German Ctr Cardiovasc Res DZHK, Partner Site Gottingen, Gottingen, Germany

[15] St Lukes Mid Amer Heart Inst, Dept Cardiovasc Dis, Sch Med, Kansas City, MO USA

[16] Univ Missouri Kansas City, Med Specialties Dept, Kansas City, MO USA

[17] ASST Spedali Civili, Cardiol, Brescia, Italy

[18] Univ Brescia, Brescia, Italy

[19] Saarland Univ, Klin Innere Med 3, Homburg, Germany

[20] Univ Alberta, Fac Med & Dent, Edmonton, AB, Canada

[21] Hosp Badalona Germans Trias & Pujol, Cardiol Dept, Barcelona, Spain

[22] CIBERCV, Barcelona, Spain

[23] Duke Univ, Sch Med, Dept Med, Durham, NC USA

[24] Wroclaw Med Univ, Inst Heart Dis, Wroclaw, Poland

[25] Univ Milano Bicocca, Papa Giovanni XXIII Hosp, Cardiovasc Dept, Bergamo, Italy

[26] Cent Michigan Univ, Coll Med, Mt Pleasant, MI USA

[27] Univ Lisbon, Santa Maria Univ Hosp, Fac Med, CAML,CCUL, Lisbon, Portugal

[28] Univ Med Ctr Groningen, Fac Med & Dent, Groningen, Netherlands

[29] INECO Neurociencias Orono, Rosario, Santa Fe, Argentina

[30] Gen Univ Hosp Prague, Clin Cardiol & Angiol, Prague, Czech Republic

[31] Erasmus MC, Univ Med Ctr, Rotterdam, Netherlands

[32] CSL Vifor, Glattbrugg, Switzerland

[33] CSL Vifor, Redwood City, CA USA

[34] Univ Mississippi, Dept Med, Jackson, MS USA

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2024年 / 84卷 / 14期

关键词：

heart failure; hyperkalemia; patiromer; mineralocorticoid receptor antagonists; renin-angiotensin system inhibitors; REDUCED EJECTION FRACTION; POTASSIUM BINDER; EFFICACY; SAFETY;

D O I：

10.1016/j.jacc.2024.05.079

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Hyperkalemia (HK) is associated with suboptimal renin-angiotensin system (RAS) inhibitor and mineralocorticoid receptor antagonist (MRA) use in heart failure with reduced ejection fraction (HFrEF). OBJECTIVES This study sought to assess characteristics and RAS inhibitor/MRA use in patients receiving patiromer during the DIAMOND (Patiromer for the Management of Hyperkalemia in Subjects Receiving RAASi Medications for the Treatment of Heart Failure) run-in phase.<br /> METHODS Patients with HFrEF and HK or past HK entered a run-in phase of <= 12 weeks with patiromer-facilitated RAS inhibitor/MRA optimization to achieve >= 50% recommended RAS inhibitor dose, 50 mg/d MRA, and normokalemia. Patients achieving these criteria (randomized group) were compared with the run-in failure group (patients not meeting the randomization criteria).<br /> RESULTS Of 1,038 patients completing the run-in, 878 (84.6%) were randomized and 160 (15.4%) were run-in failures. Overall, 422 (40.7%) had HK entering run-in with a similar frequency in the randomized and run-in failure groups (40.3% vs 42.5%; P 1 / 4 0.605). From start to the end of run-in, in the randomized group, an increase was observed in target RAS inhibitor and MRA use in patients with HK (RAS inhibitor: 76.8% to 98.6%; MRA: 35.9% to 98.6%) and past HK (RAS inhibitor: 60.5% to 98.1%; MRA: 15.6% to 98.7%). Despite not meeting the randomization criteria, an increase after runin was observed in the run-in failure group in target RAS inhibitor (52.5% to 70.6%) and MRA use (15.0% to 48.1%). This increase was observed in patients with HK (RAS inhibitor: 51.5% to 64.7%; MRA: 19.1% to 39.7%) and past HK (RAS inhibitor: 53.3% to 75.0%; MRA: 12.0% to 54.3%).<br /> CONCLUSIONS In patients with HFrEF and HK or past HK receiving suboptimal RAS inhibitor/MRA therapy, RAS inhibitor/MRA optimization increased during patiromer-facilitated run-in. (JACC. 2024;84:1295-1308)]

引用

页码：1295 / 1308

页数：14

共 50 条

[41] Mineralocorticoid Receptor Antagonist in Heart Failure with Preserved Ejection Fraction
Sugano, Akinori
Seo, Yoshihiro
Ishizu, Tomoko
Yamamoto, Masayoshi
Hamada-Harimura, Yoshie
Machino-Ohtsuka, Tomoko
Obara, Kenichi
Ishikawa, Kimito
Aonuma, Kazutaka
JOURNAL OF CARDIAC FAILURE, 2016, 22 (09) : S200 - S200
[42] Mineralocorticoid receptor antagonist use following heart failure hospitalization
Duran, Jason M.
Gad, Shady
Brann, Alison
Greenberg, Barry
ESC HEART FAILURE, 2020, 7 (02): : 482 - 492
[43] A multicenter, randomized, parallel-group pilot study of patiromer in optimizing mineralocorticoid receptor antagonist therapy in hyperkalemic heart failure patients (CONTINUE-HF): study design
Boehm, M.
Bernard, L.
Mori, C.
Mueller, B.
Fliser, D.
EUROPEAN JOURNAL OF HEART FAILURE, 2019, 21 : 105 - 106
[44] Cost-Effectiveness Analysis of Patiromer and Spironolactone Therapy in Heart Failure Patients with Hyperkalemia (vol 36, pg 1463, 2018)
Bounthavong, Mark
Butler, Javed
Dolan, Chantal M.
Dunn, Jeffrey D.
Fisher, Kathryn A.
Oestreicher, Nina
Pitt, Bertram
Hauptman, Paul J.
Veenstra, David L.
PHARMACOECONOMICS, 2019, 37 (08) : 1071 - 1071
[45] Diastolic heart failure NYHA stage IV: angiotensin converting enzyme inhibitor or angiotensin II antagonist ... or association?
Ory, J. P.
Debieuvre, D.
Bourscheid, D.
Lebrun, C.
Vitrey, F.
FUNDAMENTAL & CLINICAL PHARMACOLOGY, 2001, 15 : 122 - 122
[46] Hyperkalemia in Patients with systolic Heart Failure and Renal Failure
Keil, C.
Riedl, K.
Delle-Karth, G.
Adlbrecht, C.
JOURNAL FUR KARDIOLOGIE, 2019, 26 (1-2): : 34 - 36
[47] HYPERKALEMIA IS THE MAIN CAUSE OF MINERALOCORTICOID RECEPTOR ANTAGONISTS WITHDRAWAL AND IS ASSOCIATE WITH A WORSE PROGNOSIS IN PATIENTS WITH CHRONIC HEART FAILURE
Lisi, F.
Grande, D.
Parisi, G.
Gioia, M.
Amato, L.
Bellino, M.
Ciccone, M.
Caldarola, P.
Iacoviello, M.
EUROPEAN HEART JOURNAL SUPPLEMENTS, 2019, 21 (0E) : E230 - E231
[48] MINERALOCORTICOID RECEPTOR ANTAGONIST TREATMENT IN PATIENTS WITH RENAL INSUFFICIENCY AND ASSOCIATED RISK OF HYPERKALEMIA AND DEATH
Moller, Sara
Torp, Christian
Schou, Morten
Gislason, Gunnar
Carlson, Nicholas
Lindhardt, Morten
NEPHROLOGY DIALYSIS TRANSPLANTATION, 2022, 37 : I849 - I850
[49] Mineralocorticoid receptor antagonist treatment in patients with renal insufficiency and the associated risk of hyperkalemia and death
Moller, Sara Hedlund
Haagensen Kofod, Dea Hedlund
Schou, Morten
Torp-Pedersen, Christian
Gislason, Gunnar
Carlson, Nicholas
Lindhardt, Morten
JOURNAL OF HYPERTENSION, 2024, 42 (03) : 564 - 571
[50] Association of mineralocorticoid receptor antagonist use and in-hospital outcomes in patients with acute heart failure
Vasiliki Bistola
Panagiotis Simitsis
Dimitrios Farmakis
Ignatios Ikonomidis
Georgios Bakosis
Filippos Triposkiadis
Erifili Hatziagelaki
John Lekakis
Alexandre Mebazaa
John Parissis
Clinical Research in Cardiology, 2018, 107 : 76 - 86

← 1 2 3 4 5 →