Heart failure & cardiomyopathies
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
Pooled result · Successful MRA optimizationResult — go to the resultRelative risk 1.13 95% CI 1.02–1.25Authors' conclusion
NPB has been shown to improve GDMT outcomes by enhancing MRA optimization and reducing hyperkalaemic episodes.
Study context
- Population
- HF patients on renin-angiotensin-aldosterone system inhibitors
- Participants
- 1,432 patients6 randomized controlled trials (RCTs)
- Comparison
- New potassium binders vs placebo
- Outcome
- Successful mineralocorticoid receptor antagonist (MRA) optimization
Methodological detailsfixed-effects model, Cochrane Risk of Bias 2 assessment
- Fixed-effects model
- Cochrane Risk of Bias 2 assessment
Pooled result
As reported in the abstract
Relative risk
1.13
95% CI 1.02–1.25
P = 0.02
NPBvs Placebo
RR 1.13 (95% CI 1.02–1.25); P = 0.02
Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Patients with MRA at less than target dose | 0.72 (0.57–0.90) | P = 0.004 | |
| Hyperkalaemic episodes | 0.42 (0.24–0.72) | P = 0.002 | |
| ACEi/ARB/ANRi optimization | 1.02 (0.89–1.17) | P = 0.76 | |
| 0.20.5125Relative risk (log scale) |
| Outcome | MD (95% CI) | P value | |
|---|---|---|---|
| Serum potassium change | −0.31 (−0.61 to 0.00) | P = 0.05 | |
| −1−0.500.5Difference (linear scale) |
Safety
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Hypokalaemia | 1.57 (1.12–2.21) | P = 0.009 | |
| 0.512Relative risk (log scale) |
Original publication
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. Published 27 November 2023. doi:10.
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