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Patiromer and MRA Doses in Patients With Current or Past Hyperkalemia.
JACC Heart Fail
December 2024
UnIC@RISE, Cardiovascular Research and Development Center, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal; Heart Failure Clinic, Internal Medicine Department, Unidade Local de Saúde de Gaia/Espinho, Portugal and Centre d'Investigations Cliniques Plurithématique 1433, INSERM, Université de Lorraine, Nancy, France; F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), INSERM U1116, Centre Hospitalier Régional Universitaire de Nancy, Nancy, France. Electronic address:
Patiromer for Heart Failure Medication Optimization in Patients With Current or Past Hyperkalemia: DIAMOND Subanalysis.
JACC Heart Fail
December 2024
Department of Medicine, University of Mississippi, Jackson, Mississippi, USA.
Article Synopsis
- Study investigates the use of patiromer, a potassium binder, to improve the effectiveness of RAAS inhibitors in patients with heart failure and hyperkalemia.
- In a trial with over 1,000 patients, those with hyperkalemia were able to optimize their medication while on patiromer, showing a slight reduction in serum potassium levels compared to placebo.
- Results suggest patiromer helps patients with current hyperkalemia maintain optimal doses of medication more effectively than those with a history of hyperkalemia, enhancing treatment outcomes for heart failure management.
Patiromer Facilitates Angiotensin Inhibitor and Mineralocorticoid Antagonist Therapies in Patients With Heart Failure and Hyperkalemia.
J Am Coll Cardiol
October 2024
Department of Medicine, University of Mississippi, Jackson, Mississippi, USA.
Article Synopsis
- Hyperkalemia (HK) impacts the effectiveness of renin-angiotensin system (RAS) inhibitors and mineralocorticoid receptor antagonists (MRAs) in patients with heart failure with reduced ejection fraction (HFrEF).
- The study analyzed patients with HFrEF and either HK or a history of HK during a run-in phase designed to optimize their RAS inhibitor and MRA doses using patiromer.
- Results showed significant increases in the use of RAS inhibitors and MRAs among patients meeting the optimization criteria, indicating that patiromer helped enhance treatment for those with HK or a history of HK.
Patiromer-Facilitated Renin-Angiotensin-Aldosterone System Inhibitor Utilization in Patients with Heart Failure with or without Comorbid Chronic Kidney Disease: Subgroup Analysis of DIAMOND Randomized Trial.
Am J Nephrol
December 2024
Division of Cardiology, University of Michigan, Ann Arbor, Michigan, USA.
Article Synopsis
- - The study evaluated the effectiveness of patiromer, a drug used to manage high potassium levels (hyperkalemia), in patients with heart failure and chronic kidney disease, especially focusing on its benefits when used alongside RAAS inhibitors.
- - Results showed that patiromer was particularly effective in controlling serum potassium levels in patients with more advanced chronic kidney disease (CKD), without increasing the risk of adverse effects.
- - The research concluded that patiromer allows for safer use of RAAS inhibitors in patients with heart failure, especially those with lower estimated glomerular filtration rates (eGFR), while minimizing hyperkalemia risk.
The efficacy and safety of new potassium binders on renin-angiotensin-aldosterone system inhibitor optimization in heart failure patients: a systematic review and meta-analysis.
ESC Heart Fail
February 2024
Department of Internal Medicine, Michigan State University, East Lansing, MI, USA.
Guideline-directed medical therapy (GDMT) has improved outcomes in patients with heart failure, including the use of renin-angiotensin-aldosterone system inhibitors, which can hinder the excretion of potassium, resulting in hyperkalaemia. New potassium binders (NPBs) can prevent this adverse effect; however, the efficacy and safety of NPB for this indication have not been fully established. We conducted a systematic review and meta-analysis synthesizing randomized controlled trials (RCTs), which were retrieved by systematically searching PubMed, Web of Science, Scopus, and Cochrane through 26 April 2023.
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