AIMS Hyperkalaemia and hypokalaemia are common in heart failure and associated with worse outcomes. However, the optimal potassium range is unknown. We sought to determine the optimal range of potassium in patients with heart failure and reduced ejection fraction (< 40%) by exploring the relationship between baseline potassium level and short- and long-term outcomes using the Swedish Heart Failure Registry from 1 January 2006 to 31 December 2012. METHODS AND RESULTS We assessed the association between baseline potassium level and all-cause mortality at 30 days, 12 months, and maximal follow-up, in uni- and multivariable stratified and restricted cubic spline Cox regressions. Of 13 015 patients, 93.3% had potassium 3.5-5.0 mmol/L, 3.7% had potassium <3.5 mmol/L, and 3.0% had potassium >5.0 mmol/L. Potassium <3.5 mmol/L and >5.0 mmol/L were more common with lower estimated glomerular filtration rate and heart failure of longer duration and greater severity. The potassium level associated with the lowest hazard risk for mortality at 30 days, 12 months, and maximal follow-up was 4.2 mmol/L, and there was a steep increase in risk with both higher and lower potassium levels. In adjusted strata analyses, lower potassium was independently associated with all-cause mortality at 12 months and maximal follow-up, while higher potassium levels only increased risk at 30 days. CONCLUSION In this nationwide registry, the relationship between potassium and mortality was U-shaped, with an optimal potassium value of 4.2 mmol/L. After multivariable adjustment, hypokalaemia was associated with increased long-term mortality but hyperkalaemia was associated with increased short-term mortality.

中文翻译：

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钾水平与射血分数降低的心力衰竭预后之间的关联：瑞典心力衰竭注册中心的一项队列研究。

AIMS高钾血症和低钾血症常见于心力衰竭，并伴有不良预后。但是，最佳钾范围尚不清楚。我们试图通过使用瑞典心力衰竭登记处从2006年1月1日至2006年2月间，通过基线钾水平与短期和长期预后之间的关系来确定心力衰竭和射血分数降低（<40％）的患者的最佳钾离子范围。 2012年12月31日。方法和结果我们通过单变量和多变量分层和受限三次样条Cox回归评估了基线钾水平与30天，12个月全因死亡率和最大随访之间的关联。在13 015名患者中，93.3％的钾水平在3.5-5.0 mmol / L，3.7％的钾水平<3.5 mmol / L，3.0％的钾水平> 5.0 mmol / L。钾<3.5 mmol / L和> 5。0 mmol / L更常见，估计的肾小球滤过率较低，持续时间较长且严重程度更高的心力衰竭。钾水平与在30天，12个月内死亡的最低危险风险以及最大的随访相关，为4.2 mmol / L，并且随着钾水平的升高和降低，危险性都急剧增加。在调整的地层分析中，较低的钾与12个月的全因死亡率和最大的随访独立相关，而较高的钾水平仅在30天增加风险。结论在这个全国性的登记册中，钾与死亡率之间的关系呈U形，最佳钾值为4.2 mmol / L。经过多变量调整后