Abstract：
BACKGROUND:A previous randomized controlled trial evaluating the use of spironolactone in heart failure patients reported a low risk of hyperkalemia (2%) and renal insufficiency (0%). Because treatments for heart failure have changed since the benefits of spironolactone were reported, the prevalence of these complications may differ in current clinical practice. We therefore sought to determine the prevalence and clinical associations of hyperkalemia and renal insufficiency in heart failure patients treated with spironolactone. METHODS:We performed a case control study of heart failure patients treated with spironolactone in our clinical practice. Cases were patients who developed hyperkalemia (K(+) >5.0 mEq/L) or renal insufficiency (Cr >or=2.5 mg/dL), and they were compared to 2 randomly selected controls per case. Clinical characteristics, medications, and serum chemistries at baseline and follow-up time periods were compared. RESULTS:Sixty-seven of 926 patients (7.2%) required discontinuation of spironolactone due to hyperkalemia (n = 33) or renal failure (n = 34). Patients who developed hyperkalemia were older and more likely to have diabetes, had higher baseline serum potassium levels and lower baseline potassium supplement doses, and were more likely to be treated with beta-blockers than controls (n = 134). Patients who developed renal insufficiency had lower baseline body weight and higher baseline serum creatinine, required higher doses of loop diuretics, and were more likely to be treated with thiazide diuretics than controls. CONCLUSIONS:Spironolactone-induced hyperkalemia and renal insufficiency are more common in our clinical experience than reported previously. This difference is explained by patient comorbidities and more frequent use of beta-blockers.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Tamirisa KP,Aaronson KD,Koelling TMdoi
10.1016/j.ahj.2004.10.005subject
Has Abstractpub_date
2004-12-01 00:00:00pages
971-8issue
6eissn
0002-8703issn
1097-6744pii
S0002870304007501journal_volume
148pub_type
杂志文章abstract：:High levels of endogenous plasma catecholamines in patients with severe congestive heart failure induce a down-regulation of the myocardial beta-adrenoreceptors and thus cause adrenoreceptor agonists, such as dobutamine, to be less effective in the treatment of these patients. Phosphodiesterase III inhibitors work ind...
journal_title：American heart journal
pub_type： 临床试验,杂志文章
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更新日期：1991-06-01 00:00:00
abstract：BACKGROUND:Peculiar asynergy, which consists of hypokinesis or akinesis from the mid portion to the apical area and hyperkinesis of the basal area on contrast left ventriculogram, is rare. Because the end-systolic left ventriculogram looks like a "tako-tsubo," which was used for trapping octopuses in Japan, we proposed...
journal_title：American heart journal
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journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(84)90352-1
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journal_title：American heart journal
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abstract：BACKGROUND:The acute benefits of platelet glycoprotein IIb/IIIa inhibitors for non-ST-segment elevation acute coronary syndromes (NSTE ACS) remain unclear. METHODS:In this pilot trial, 311 patients with NSTE ACS were randomly assigned in the emergency department to double-blinded therapy with eptifibatide or placebo f...
journal_title：American heart journal
pub_type： 临床试验,杂志文章,随机对照试验
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journal_title：American heart journal
pub_type： 临床试验,杂志文章,多中心研究
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journal_title：American heart journal
pub_type： 杂志文章,评审
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journal_title：American heart journal
pub_type： 杂志文章,评审
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更新日期：1987-02-01 00:00:00
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pub_type： 杂志文章,meta分析
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journal_title：American heart journal
pub_type： 杂志文章
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pub_type： 杂志文章,随机对照试验
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更新日期：2018-03-01 00:00:00
abstract：BACKGROUND:Relationships between long-term use and level of dual antiplatelet therapy and outcomes after drug-eluting stent implantation are not well established. METHODS:This is a retrospective cohort study of 9,256 patients receiving drug-eluting stents between January 2003 and August 2006. We classified patients ac...
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pub_type： 杂志文章
doi：10.1016/j.ahj.2009.11.031
更新日期：2010-03-01 00:00:00
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journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(88)90334-1
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journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(83)90116-3
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journal_title：American heart journal
pub_type： 杂志文章
doi：10.1067/mhj.2000.110288
更新日期：2000-11-01 00:00:00
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journal_title：American heart journal
pub_type： 杂志文章,评审
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pub_type： 杂志文章
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journal_title：American heart journal
pub_type： 杂志文章
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更新日期：1982-01-01 00:00:00
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pub_type： 杂志文章,评审
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更新日期：1992-04-01 00:00:00
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journal_title：American heart journal
pub_type： 杂志文章,多中心研究
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更新日期：1999-04-01 00:00:00
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journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(84)90825-1
更新日期：1984-05-01 00:00:00
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pub_type： 临床试验,杂志文章
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更新日期：1984-10-01 00:00:00
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pub_type： 杂志文章,多中心研究,随机对照试验
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更新日期：2010-04-01 00:00:00
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journal_title：American heart journal
pub_type： 杂志文章
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更新日期：2007-07-01 00:00:00
abstract：:Quinidine serum levels and pharmacokinetic data were assessed during steady state therapy with oral quinidine sulfate in 19 hospitalized patients who were being treated for ventricular arrhythmias. A new high performance liquid chromatography assay was employed. Four patients were studied both after the first dose of ...
journal_title：American heart journal
pub_type： 杂志文章
doi：10.1016/0002-8703(79)90467-8
更新日期：1979-12-01 00:00:00
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journal_title：American heart journal
pub_type： 杂志文章,评审
doi：10.1067/mhj.2000.103934
更新日期：2000-02-01 00:00:00
