{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:56:01Z","timestamp":1791276961151,"version":"4.1.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":32,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Hyperkalaemia complicates heart failure (HF) and may limit guideline-directed therapy. Potassium binders differ in pharmacologic properties and sodium load, raising cardiovascular safety concerns. This study compared cardiovascular outcomes associated with patiromer, sodium zirconium cyclosilicate (SZC), and sodium polystyrene sulfonate (SPS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective observational study was conducted within the TriNetX network including adults with HF and hyperkalaemia initiating patiromer, SZC, or SPS (2019\u20132024). Three pairwise 1:1 propensity-matched comparisons were performed. Follow-up was up to 365 days (mean 0.7 \u00b1 0.4 years). Outcomes included death, HF hospitalization, cardiovascular hospitalization, myocardial infarction, incident atrial fibrillation (AF), pulmonary oedema\/cardiogenic shock, end-stage kidney disease (ESKD), and ventricular tachyarrhythmia\/cardiac arrest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After matching, 5589 patients per group were included for patiromer vs SPS, 15 769 per group for SZC vs SPS, and 4381 per group for SZC vs patiromer. Compared with SPS, patiromer was associated with lower risk of HF hospitalization (hazard ratio [HR] 0.573, 95% confidence interval [CI] 0.535\u20130.613) and cardiovascular hospitalization (HR 0.737, 95% CI 0.697\u20130.779), but slightly higher mortality (HR 1.096, 95% CI 1.027\u20131.170). SZC was associated with higher risks of death (HR 1.139, 95% CI 1.095\u20131.185), HF hospitalization (HR 1.184, 95% CI 1.143\u20131.225), myocardial infarction (HR 1.132, 95% CI 1.018\u20131.260), ESKD (HR 1.137, 95% CI 1.082\u20131.196), and cardiovascular hospitalization (HR 1.193, 95% CI 1.157\u20131.229) compared with SPS. SZC was associated with higher HF hospitalization (HR 2.735, 95% CI 2.519\u20132.969) and cardiovascular hospitalization (HR 1.914, 95% CI 1.797\u20132.037) than patiromer, with no significant difference in mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this observational study of HF with hyperkalaemia, potassium binders were associated with different cardiovascular outcomes. These findings are hypothesis-generating and support randomized trials powered for clinical endpoints.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eschf\/xvag248","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T11:54:59Z","timestamp":1790164499000},"source":"Crossref","is-referenced-by-count":0,"title":["Cardiovascular outcomes with potassium binders in patients with heart failure and hyperkalaemia"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9267-1658","authenticated-orcid":false,"given":"Laurent","family":"Fauchier","sequence":"first","affiliation":[{"name":"Department of Cardiology, Centre Hospitalier Universitaire Trousseau et Facult\u00e9 de M\u00e9decine, INSERM UMR1327 ISCHEMIA, Universit\u00e9 Fran\u00e7ois Rabelais , Avenue de la R\u00e9publique, Tours 37044 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mickael","family":"Guglieri","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Centre Hospitalier Universitaire Trousseau et Facult\u00e9 de M\u00e9decine, INSERM UMR1327 ISCHEMIA, Universit\u00e9 Fran\u00e7ois Rabelais , Avenue de la R\u00e9publique, Tours 37044 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2470-0760","authenticated-orcid":false,"given":"Thibault","family":"Lenormand","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Centre Hospitalier Universitaire Trousseau et Facult\u00e9 de M\u00e9decine, INSERM UMR1327 ISCHEMIA, Universit\u00e9 Fran\u00e7ois Rabelais , Avenue de la R\u00e9publique, Tours 37044 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thibaud","family":"Genet","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Centre Hospitalier Universitaire Trousseau et Facult\u00e9 de M\u00e9decine, INSERM UMR1327 ISCHEMIA, Universit\u00e9 Fran\u00e7ois Rabelais , Avenue de la R\u00e9publique, Tours 37044 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3449-1800","authenticated-orcid":false,"given":"Arnaud","family":"Bisson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Centre Hospitalier Universitaire Trousseau et Facult\u00e9 de M\u00e9decine, INSERM UMR1327 ISCHEMIA, Universit\u00e9 Fran\u00e7ois Rabelais , Avenue de la R\u00e9publique, Tours 37044 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"2026100604475387600_xvag248-B1","doi-asserted-by":"publisher","first-page":"2836","DOI":"10.1016\/j.jacc.2020.04.021","article-title":"Abnormalities of potassium in heart failure: JACC state-of-the-art review","volume":"75","author":"Ferreira","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2026100604475387600_xvag248-B2","doi-asserted-by":"publisher","first-page":"2410","DOI":"10.1002\/ejhf.3800","article-title":"Management of patients with heart failure at high risk of hyperkalaemia: the CARE-HK in HF registry","volume":"27","author":"Greene","year":"2025","journal-title":"Eur J Heart Fail"},{"key":"2026100604475387600_xvag248-B3","doi-asserted-by":"publisher","first-page":"1414","DOI":"10.1016\/j.cardfail.2022.04.003","article-title":"Risk of hospitalization for heart failure in patients with hyperkalemia treated with sodium zirconium cyclosilicate versus patiromer","volume":"28","author":"Zhuo","year":"2022","journal-title":"J Card Fail"},{"key":"2026100604475387600_xvag248-B4","doi-asserted-by":"publisher","first-page":"1835","DOI":"10.34067\/KID.0000000586","article-title":"The association of heart failure and edema events between patients initiating sodium zirconium cyclosilicate or patiromer","volume":"5","author":"Desai","year":"2024","journal-title":"Kidney360"},{"key":"2026100604475387600_xvag248-B5","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1016\/j.jacc.2024.11.014","article-title":"Sodium zirconium cyclosilicate for management of hyperkalemia during spironolactone optimization in patients with heart failure","volume":"85","author":"Kosiborod","year":"2025","journal-title":"J Am Coll Cardiol"},{"key":"2026100604475387600_xvag248-B6","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.ejim.2023.07.031","article-title":"Short-term prognosis of changes in plasma potassium following an episode of hyperkalaemia in patients with chronic heart failure","volume":"118","author":"Jonsson","year":"2023","journal-title":"Eur J Intern Med"},{"key":"2026100604475387600_xvag248-B7","doi-asserted-by":"publisher","first-page":"1378","DOI":"10.1002\/ejhf.1793","article-title":"Unravelling the interplay between hyperkalaemia, renin-angiotensin-aldosterone inhibitor use and clinical outcomes. 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