Cardiology Letters 2020, 29(4):235-239

Potassium disturbances and some drugs in seniors with atrial fibrillation (data from SAFIS study)

Dúbrava M¹, Németh F², Drobná T³, Gerlich L⁴

¹ Klinika geriatrie LFUK a UNB Bratislava

² Oddelenia vnútorného lekárstva a geriatrie, FNsP J. A. Reimana v Prešove

³ Oddelenia geriatrie a dlhodobo chorých, FN Trenčín

⁴ Oddelenia dlhodobo chorých NsP Prievidza - nemocnica Bojnice, Slovenská republika

Atrial fibrillation (AF) is the most frequent arrhythmia in seniors and can negatively influence their quality of life. In the "Slovak audit of Atrial FIbrillation in Seniors" study (4252 consecutive patients with AF aged ≥ 65 years [mean age 80.9 years], hospitalised during 2.5 years in 4 acute geriatric departments) serum potassium level was one of the analysed parameters. We proved that both hypo- and hyperkalemia are quite frequent. This can be related to the drugs used as well (we analysed 9 drugs / drug groups with the potential known to influence kalemia). We could not prove an association between diuretics and hypokalemia. Neither did a cumulation of drugs with hyperkalemic potential lead to an increased frequency of hyperkalemia: on the contrary, they significantly decreased this risk at discharge. We proved the expected mild increase in risk of hyperkalemia under sporinolactone medication, but only at admission (OR 2.06), at discharge spironolactone was "protective" against hyperkalemia. Surprisingly we revealed an association between low molecular weight heparin (at discharge) and hyperkalemia (OR 2.01), and between non-steroidal anti-inflammatory drugs (at admission) and hyperkalemia (OR 1.76). Thus in real (hospital) life we can control the expected threats of potassium disturbances induced by diuretics and drugs influencing the renin - angiotensin - aldosterone system in an effective way. This is confirmed also by the finding that potassium dysbalance occurred in all investigated drugs / drug groups less frequently at discharge than at admission. Kalemia and its disturbances can be easily and cheaply tested and are well treatable. Appropriate attention to them should be paid in seniors (with AF) during prehospital and hospital health care delivery.

Keywords: atrial fibrillation; geriatrics; hypokalemia; hyperkalemia; drugs; SAFIS

Published: April 1, 2020  Show citation