Heart failure & cardiomyopathies
Elevated Blood Bicarbonate Levels and Long-Term Adverse Outcomes in Patients with Chronic Heart Failure
Authors' conclusion
Elevated blood HCO3 - levels may signify enhanced proximal nephron activation and loop diuretic resistance, leading to long-term adverse outcomes in patients with CHF, even within a normal pH range.
Study context
- Population
- Hospitalised patients with chronic HF with arterial blood sampling and neutral pH (7.35–7.45); mean age 68.6 ± 14.6, 62% male
- Participants
- 694 patients
- Exposure
- HCO3- >26 mmol/L vs 22–26 mmol/L vs <22 mmol/L
- HCO3- > 26 mmol/Ln = 120
- HCO3- 22–26n = 379reference
- HCO3- < 22 mmol/Ln = 195
- Outcome
- Cardiac death and HF-related rehospitalisation
- Follow-up
- Median 1950 days
Main finding
As reported in the abstract
Cardiac death; HF-related rehospitalisation
- HCO3- > 26 mmol/L · cardiac death; multivariable Cox
- HR 2.31; P < 0.01
- HCO3- > 26 mmol/L · HF rehospitalisation; multivariable Cox
- HR 1.69; P = 0.02
- HCO3- < 22 mmol/L · cardiac death; multivariable Cox
- HR 0.99; P = 0.98
- HCO3- < 22 mmol/L · HF rehospitalisation; multivariable Cox
- HR 1.19; P = 0.43
- Kaplan-Meier: HCO3- > 26 mmol/L had lowest event-free survival from cardiac death and HF rehospitalisation
- P < 0.01 and 0.03
Observational data: associations, not effects.
Further findings
Baseline characteristics, HCO3- > 26 mmol/L vs others
- More loop diuretic use, higher serum sodium, lower potassium; LVEF did not differ
Original publication
Elevated Blood Bicarbonate Levels and Long-Term Adverse Outcomes in Patients with Chronic Heart Failure. ESC Heart Fail. Published 5 July 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →