{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T22:33:12Z","timestamp":1791325992934,"version":"4.3.1"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":1055,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T00:00:00Z","timestamp":1671753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Several patients with heart failure and reduced ejection fraction (HFrEF) do not receive renin\u2013angiotensin\u2013aldosterone system (RAAS) inhibitors at the recommended dose or at all, frequently due to actual or feared hyperkalaemia. Sodium zirconium cyclosilicate (SZC) is an orally administered non-absorbed intestinal potassium binder proven to lower serum potassium concentrations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>PRIORITIZE-HF was an international, multicentre, parallel-group, randomized, double-blind, placebo-controlled study to evaluate the benefits and risks of using SZC to intensify RAAS inhibitor therapy. Patients with symptomatic HFrEF were eligible and randomly assigned to receive SZC 5 g or placebo once daily for 12 weeks. Doses of study medication and RAAS inhibitors were titrated during the treatment period. The primary endpoint was the proportion of patients at 12 weeks in the following categories: (i) any RAAS inhibitor at less than target dose, and no MRA; (ii) any RAAS inhibitor at target dose and no MRA; (ii) MRA at less than target dose; and (iv) MRA at target dose. Due to challenges in participant management related to the COVID-19 pandemic, the study was prematurely terminated with 182 randomized patients. There was no statistically significant difference in the distribution of patients by RAAS inhibitor treatment categories at 3 months (P = 0.43). The proportion of patients at target MRA dose was numerically higher in the SZC group (56.4%) compared with the placebo group (47.0%). Overall, SZC was well tolerated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PRIORITIZE-HF was terminated prematurely due to COVID-19 and did not demonstrate a statistically significant increase in the intensity of RAAS inhibitor therapies with the potassium-reducing agent SZC compared with placebo.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14268","type":"journal-article","created":{"date-parts":[[2022,12,24]],"date-time":"2022-12-24T01:43:29Z","timestamp":1671846209000},"page":"1066-1076","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Potassium Reduction with Sodium Zirconium Cyclosilicate in Patients with Heart Failure"],"prefix":"10.1093","volume":"10","author":[{"given":"Jean-Claude","family":"Tardif","sequence":"first","affiliation":[{"name":"Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al , 5000 Belanger Street East, Montreal, H1T1C8, Quebec ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Rouleau","sequence":"additional","affiliation":[{"name":"Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al , 5000 Belanger Street East, Montreal, H1T1C8, Quebec ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn M.","family":"Chertow","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine , Palo Alto, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman","family":"Al-Shurbaji","sequence":"additional","affiliation":[{"name":"AstraZeneca , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Lisovskaja","sequence":"additional","affiliation":[{"name":"AstraZeneca , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Gustavson","sequence":"additional","affiliation":[{"name":"AstraZeneca , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanli","family":"Zhao","sequence":"additional","affiliation":[{"name":"AstraZeneca , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Bouabdallaoui","sequence":"additional","affiliation":[{"name":"Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al , 5000 Belanger Street East, Montreal, H1T1C8, Quebec ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akshay S.","family":"Desai","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital, Harvard Medical School , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Chernyavskiy","sequence":"additional","affiliation":[{"name":"E. Meshalkin National Medical Research Center, Ministry of Health of the Russia Federation , Moscow ,","place":["Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Evsina","sequence":"additional","affiliation":[{"name":"Aramil City Hospital , Aramil ,","place":["Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9la","family":"Merkely","sequence":"additional","affiliation":[{"name":"Semmelweis Universtiy Heart and Vascular Center , Budapest ,","place":["Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.V.","family":"McMurray","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular and Medical Sciences, British Heart Foundation Centre of Research, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc A.","family":"Pfeffer","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital, Harvard Medical School , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,12,23]]},"reference":[{"key":"2026012114110595900_ehf214268-bib-0001","doi-asserted-by":"crossref","first-page":"e139","DOI":"10.1161\/CIR.0000000000000757","article-title":"Heart Disease and Stroke Statistics\u20132020 update: a report from the American Heart Association","volume":"141","author":"Virani","year":"2020","journal-title":"Circulation"},{"key":"2026012114110595900_ehf214268-bib-0002","doi-asserted-by":"crossref","first-page":"e137","DOI":"10.1161\/CIR.0000000000000509","article-title":"2017 ACC\/AHA\/HFSA focused update of the 2013 ACCF\/AHA guideline for the management of heart failure: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America","volume":"136","author":"Yancy","year":"2017","journal-title":"Circulation"},{"key":"2026012114110595900_ehf214268-bib-0003","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur Heart J"},{"key":"2026012114110595900_ehf214268-bib-0004","first-page":"s311","article-title":"Evaluation of clinical outcomes and costs based on prescribed dose level of renin\u2013angiotensin\u2013aldosterone system inhibitors","volume":"22","author":"Epstein","year":"2016","journal-title":"Am J Manag Care"},{"key":"2026012114110595900_ehf214268-bib-0005","article-title":"Hyperkalemia with mineralocorticoid receptor antagonist use in people with CKD: understanding and mitigating the risks","volume":"17","author":"Epstein","year":"2021","journal-title":"Clin J Am Soc Nephrol"},{"key":"2026012114110595900_ehf214268-bib-0006","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1016\/j.amjmed.2015.05.040","article-title":"Management of hyperkalemia: an update for the internist","volume":"128","author":"Kovesdy","year":"2015","journal-title":"Am J Med"},{"key":"2026012114110595900_ehf214268-bib-0007","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1159\/000437151","article-title":"Serum potassium, end-stage renal disease and mortality in chronic kidney disease","volume":"41","author":"Nakhoul","year":"2015","journal-title":"Am J Nephrol"},{"key":"2026012114110595900_ehf214268-bib-0008","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1001\/archinternmed.2009.132","article-title":"The frequency of hyperkalemia and its significance in chronic kidney disease","volume":"169","author":"Einhorn","year":"2009","journal-title":"Arch Intern Med"},{"key":"2026012114110595900_ehf214268-bib-0009","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1007\/s40265-018-0991-6","article-title":"Sodium zirconium Cyclosilicate: a review in hyperkalaemia","volume":"78","author":"Hoy","year":"2018","journal-title":"Drugs"},{"key":"2026012114110595900_ehf214268-bib-0010","first-page":"139","article-title":"Personalized treatment of heart failure with biomarker guidance using a novel disease severity score","volume":"30","author":"Vasudevan","year":"2017","journal-title":"Proc (Bayl Univ Med Cent)"},{"key":"2026012114110595900_ehf214268-bib-0011","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1002\/pst.1549","article-title":"Missing data in clinical trials: from clinical assumptions to statistical analysis using pattern mixture models","volume":"12","author":"Ratitch","year":"2013","journal-title":"Pharm Stat"},{"key":"2026012114110595900_ehf214268-bib-0012","doi-asserted-by":"crossref","first-page":"2223","DOI":"10.1001\/jama.2014.15688","article-title":"Effect of sodium zirconium cyclosilicate on potassium lowering for 28 days among outpatients with hyperkalemia: the HARMONIZE randomized clinical trial","volume":"312","author":"Kosiborod","year":"2014","journal-title":"JAMA"},{"key":"2026012114110595900_ehf214268-bib-0013","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1056\/NEJMoa1411487","article-title":"Sodium zirconium cyclosilicate in hyperkalemia","volume":"372","author":"Packham","year":"2015","journal-title":"N Engl J Med"},{"key":"2026012114110595900_ehf214268-bib-0014","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1056\/NEJMoa1410853","article-title":"Patiromer in patients with kidney disease and hyperkalemia receiving RAAS inhibitors","volume":"372","author":"Weir","year":"2015","journal-title":"N Engl J Med"},{"key":"2026012114110595900_ehf214268-bib-0015","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1016\/S0140-6736(19)32135-X","article-title":"Patiromer versus placebo to enable spironolactone use in patients with resistant hypertension and chronic kidney disease (AMBER): a phase 2, randomised, double-blind, placebo-controlled trial","volume":"394","author":"Agarwal","year":"2019","journal-title":"Lancet"},{"key":"2026012114110595900_ehf214268-bib-0016","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1002\/ejhf.2386","article-title":"Patiromer for the management of hyperkalaemia in patients receiving renin\u2013angiotensin\u2013aldosterone system inhibitors for heart failure: design and rationale of the DIAMOND trial","volume":"24","author":"Butler","year":"2022","journal-title":"Eur J Heart Fail"},{"key":"2026012114110595900_ehf214268-bib-0017","doi-asserted-by":"crossref","first-page":"4362","DOI":"10.1093\/eurheartj\/ehac401","article-title":"Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction: the DIAMOND trial","volume":"43","author":"Butler","year":"2022","journal-title":"Eur Heart J"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.14268","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.14268","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/10\/2\/1066\/65051157\/eschf_10_2_1066.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/10\/2\/1066\/65051157\/eschf_10_2_1066.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:12:21Z","timestamp":1769022741000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/10\/2\/1066\/8304859"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,23]]},"references-count":17,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,12,23]]},"published-print":{"date-parts":[[2023,4,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.14268","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,4]]},"published":{"date-parts":[[2022,12,23]]},"assertion":[{"value":"2022-02-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}