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Incidence and Predictors of Hyperkalemia in Patients With Heart Failure

An Analysis of the CHARM Program

Akshay S. Desai, MD^_*,_*, Karl Swedberg, MD, PhD, FACC, John J.V. McMurray, MD, FACC, Christopher B. Granger, MD, FACC, Salim Yusuf, MD, Dphil, FACC^||, James B. Young, MD, FACC^¶, Mark E. Dunlap, MD, FACC^#, Scott D. Solomon, MD^_*, James W. Hainer, MD^_**, Bertil Olofsson, PhD, Eric L. Michelson, MD, FACC^_**, Marc A. Pfeffer, MD, PhD, FACC^_* CHARM Program Investigators

^_* Department of Cardiology, Brigham and Women's Hospital, Boston, Massachusetts
Emergency and Cardiovascular Medicine, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden
Department of Cardiology, Western Infirmary, Glasgow, Scotland
Department of Cardiology, Duke University Medical Center, Durham, North Carolina
^|| Department of Medicine, HGM-McMaster Clinic, Hamilton, Ontario, Canada
^¶ Department of Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio
^# Department of Cardiology, Case Western Reserve University and VA Medical Center, Cleveland, Ohio
^_** AstraZeneca LP, Wilmington, Delaware
AstraZeneca R&D, Mölndal, Sweden

View larger version (24K): [in this window] [in a new window] [Download PPT slide]   Figure 1 Impact of Candesartan on Hyperkalemia Risk in CHARM-Overall, by Subgroups Subgroups assigned according to patient characteristics at baseline. Baseline values for serum potassium and creatinine were available only for the subset of patients enrolled in North America. ACE = angiotensin-converting enzyme.

View larger version (17K): [in this window] [in a new window] [Download PPT slide]   Figure 2 Impact of Candesartan on CV Death or HF Hospitalization, by Subgroups, CHARM-Overall Subgroups are identical to those in Figure 1. CV = cardiovascular; HF = heart failure; other abbreviations as in Figure 1.

View larger version (19K): [in this window] [in a new window] [Download PPT slide]   Figure 3 Cumulative Incidence of Significant Hyperkalemia, CHARM-Overall Solid lines represent candesartan-treated patients and dashed lines represent placebo-treated patients. "Any Hyperkalemia" (black) indicates hyperkalemia associated with dose reduction, dose discontinuation, hospitalization, or death. "Serious Hyperkalemia" (red) refers only to those hyperkalemia events associated with hospitalization or death. HR = hazard ratio (95% confidence interval).