HDCN Abstract:  ASN Annual Meeting 2020 -- Digital Meeting  

Kristensen SL, Docherty KF, Jhund P, et al.

Dapagliflozin Reduces the Risk of Hyperkalaemia in Patients with Heart Failure and Reduced Ejection Fraction: A Secondary Analysis from DAPA- HF

ASN Annual Meeting 2020 -- Digital Meeting
J Am Soc Nephrol (Oct) 31:21A 2020

BACKGROUND

Hyperkalaemia often limits the use of mineralocorticoid receptor antagonists (MRAs) in patients with heart failure and reduced ejection fraction (HFrEF), denying these patients a life-saving therapy.

METHODS

The risk of developing mild hyperkalaemia (potassium > 5.5 mmol/L) and moderate/severe hyperkalaemia (>6.0 mmol/L) was examined in the Dapagliflozin And Prevention of Adverse-outcomes in Heart Failure trial (DAPA-HF) according to background MRA use, and randomized treatment assignment, by use of Cox regression analyses.

RESULTS

Overall, 3370 (70.1%) patients in DAPA-HF were treated with an MRA. Mild hyperkalaemia and moderate/severe hyperkalaemia occurred in 182 (11.1%) and 23 (1.4%) patients treated with dapagliflozin as compared to 204 (12.6%) and 40 (2.4%) of patients given placebo (Table and Figure). This yielded a hazard ratio (HR) of 0.86 (0.70- 1.05) for mild hyperkalaemia and 0.50 (0.29, 0.85) for moderate/severe hyperkalaemia, comparing dapagliflozin to placebo.

CONCLUSION

Patients with HFrEF and taking an MRA who were randomized to dapagliflozin had half the incidence of moderate/severe hyperkalaemia, compared with those randomized to placebo.


Incident hyperkalaemia in DAPA- HF


Cumulative incidence of hyperkalaemia in patients taking MRA at baseline

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