Arrhythmias & electrophysiologySecondary analysis
Potassium-Increasing Regimens in Patients at High Risk of Ventricular Arrhythmias: A Prespecified Observational Analysis of the Randomized POTCAST Trial
- Secondary analysis of the POTCAST randomised trial
- prespecified observational analysis
Authors' conclusion
Treatment with MRA, potassium-supplements or both increased potassium levels. All regimens were associated with numerically lower endpoint rates than controls. We detected no statistically significant differences in endpoints or safety between regimens.
Study context
- Population
- Patients with Implantable Cardioverter-Defibrillators (ICDs) who completed potassium up-titration in POTCAST600 control and 572 intervention participants
- Comparison
- Controls vs MRA vs Potassium-supplements vs Combination-therapy
- Controlsn = 600reference
- Primary endpoint
- Composite of:
- Sustained ventricular arrhythmia
- Appropriate ICD-therapy
- Hospitalization for arrhythmia or heart-failure or all-cause mortality
Primary result
As reported in the abstract
Further findings
| Outcome | Controls | MRA | Potassium-supplements | Combination-therapy |
|---|---|---|---|---|
| Plasma potassium · 6 months | ||||
| baseline | Not reported in the abstract | 4.12 | 3.99 | 3.98 |
| 6 months | Not reported in the abstract | 4.27 | 4.24 | 4.34 |
- Plasma potassium: MRA p=0.004
- Plasma potassium: potassium-supplements p<0.001
- Plasma potassium: combination-therapy p<0.001
Safety
Hypokalemia
Hyperkalemia
- Hyperkalemia: p>0.1 between regimens
Original publication
Potassium-Increasing Regimens in Patients at High Risk of Ventricular Arrhythmias: A Prespecified Observational Analysis of the Randomized POTCAST Trial. Europace. Published 6 October 2026. doi:10.1093/europace/euag272
Summarised from the published abstract; every number is checked against it