Empagliflozin effectively regulates Serum potassium in Heart Failure, study

Key findings of the study are,

• Patients with high potassium at baseline were more frequently diagnosed with diabetes and ischaemic HF aetiology and had lower left ventricular ejection fraction and estimated glomerular filtration rate but were more frequently treated with sacubitril/valsartan or mineralocorticoid receptor antagonists.

• Empagliflozin reduced the composite of investigator-reported hyperkalaemia or initiation potassium binders, compared with the placebo

• Empagliflozin reduced hyperkalaemia rates regardless of the definition used (serum potassium >5.5 mmol/l: 8.6% vs. 9.9%, HR 0.85, 95% CI 0.74–0.97, P = 0.017; serum potassium >6.0 mmol/l: 1.9% vs. 2.9%, HR 0.62, 95% CI 0.48–0.81, P < 0.001).

• The incidence of hypokalaemia (investigator-reported or serum potassium <3.0 mmol/l) was not significantly increased with empagliflozin.

From the study data, the investigators conclude that both hyper- and hypokalemia are associated with worse outcomes. Empagliflozin (vs. placebo) reduced the rate of new-onset hyperkalaemia or new initiation of potassium binders without increasing the incidence of hypokalaemia in a significant manner.

The study findings are clinically important and expand the potential benefits of Empagliflozin in HF, the authors wrote.

João Pedro Ferreira, Faiez Zannad, Javed Butler, Gerasimos Filipattos, Ivana Ritter, Elke Schüler, Bettina J Kraus, Stuart J. Pocock, Stefan D. Anker, Milton Packer, Empagliflozin and serum potassium in heart failure: an analysis from EMPEROR-Pooled, European Heart Journal, 2022, ehac306, https://doi.org/10.1093/eurheartj/ehac306