Logo do repositório
 
Publicação

Hipercaliemia e otimização dos inibidores do sistema renina-angiotensina-aldosterona na insuficiência cardíaca crónica com disfunção sistólica

2020-09Recensão Acesso aberto
Ver registo simples
dc.contributor.authorFonseca, Cândida
dc.contributor.authorBrito, Dulce
dc.contributor.authorBranco, Patrícia
dc.contributor.authorFrazão, João Miguel
dc.contributor.authorSilva-Cardoso, José
dc.contributor.authorBettencourt, Paulo
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblSociedade Portuguesa de Cardiologia | Elsevier
dc.date.accessioned2023-01-13T22:13:43Z
dc.date.available2023-01-13T22:13:43Z
dc.date.issued2020-09
dc.description.abstractIntroduction and Objectives: Renin-angiotensin-aldosterone system inhibitors (RAASi) are the cornerstone of treatment of heart failure with reduced ejection fraction (HFrEF). RAASi optimization in real-life care is challenged by hyperkalemia, a potentially fatal adverse event, which can necessitate downtitration or discontinuation of RAASi and negatively impact survival in HFrEF. The literature on this problem is sparse. We performed a systematic review of studies on HFrEF to investigate the prevalence, incidence, and risk factors of hyperkalemia, RAASi prescription rates, frequency of RAASi downtitration or discontinuation due to hyperkalemia, and the potential negative effect of the latter on prognosis. Methods: We conducted a MEDLINE (PubMed) search including observational and interventional studies published between January 1987 and May 2018. Results: A total of 30 observational and 18 interventional studies were included in the review. The incidence of hyperkalemia reported was between 0% and 63% in observational studies and was between 0% and 30% in clinical trials. Risk factors for hyperkalemia included RAASi prescription, older age, diabetes, and chronic kidney disease. In real-life studies, RAASi were downtitrated or discontinued in 3-22% of HFrEF patients; hyperkalemia was the reported cause in 5% of cases. No reports were found on the impact on prognosis of RAASi downtitration or discontinuation due to hyperkalemia. Conclusions: Hyperkalemia and RAASi downtitration or discontinuation are frequent, particularly in real-life HFrEF studies. Further research is needed to clarify the role of RAASi downtitration or discontinuation due to hyperkalemia and to assess its long-term prognostic impact in HFrEF patients.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent1624932
dc.identifier.doi10.1016/j.repc.2020.03.015
dc.identifier.issn0870-2551
dc.identifier.otherPURE: 19827121
dc.identifier.otherPURE UUID: 999e76a4-5f39-4bcd-8d69-45ad3b5b579b
dc.identifier.otherScopus: 85089730958
dc.identifier.otherPubMed: 32868174
dc.identifier.otherWOS: 000572678000007
dc.identifier.urihttp://hdl.handle.net/10362/147540
dc.identifier.urlhttps://www.scopus.com/pages/publications/85089730958
dc.language.isopor
dc.peerreviewedyes
dc.subjectClinical decision-making
dc.subjectClinical outcomes
dc.subjectDrug therapy
dc.subjectHeart failure
dc.subjectHyperkalemia
dc.subjectRenin-angiotensin-aldosterone system inhibitors
dc.subjectCardiology and Cardiovascular Medicine
dc.subjectSDG 3 - Good Health and Well-being
dc.titleHipercaliemia e otimização dos inibidores do sistema renina-angiotensina-aldosterona na insuficiência cardíaca crónica com disfunção sistólicapt
dc.title.alternativeHyperkalemia and management of renin-angiotensin-aldosterone system inhibitors in chronic heart failure with reduced ejection fractionA systematic reviewen
dc.title.subtitleuma revisão sistemáticapt
dc.typereview
degois.publication.firstPage517
degois.publication.issue9
degois.publication.lastPage541
degois.publication.titleRevista Portuguesa de Cardiologia
degois.publication.volume39
dspace.entity.typePublication
rcaap.rightsopenAccess

Ficheiros

Principais
A mostrar 1 - 1 de 1
Miniatura
Nome:
1_s2.0_S0870255120303474_main.pdf
Tamanho:
1.55 MB
Formato:
Adobe Portable Document Format
Ver/Abrir

Coleções

NMS - Artigos em revista nacional com arbitragem científica