{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:51:46Z","timestamp":1791276706516,"version":"4.1.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>The POTCAST trial (n=1,200) showed that targeting high-normal plasma potassium levels reduced ventricular arrhythmias in patients with Implantable Cardioverter-Defibrillators (ICDs). We compared changes in plasma potassium and described outcomes across the three regimens used to increase plasma potassium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We studied 600 control participants and 572 intervention participants who completed potassium up-titration in POTCAST. Participants in the intervention arm were categorized according to treatment after plasma-potassium up-titration into: a) mineralocorticoid-receptor antagonists (MRAs) monotherapy, b) potassium-supplement monotherapy, or c) combination-therapy with both. The primary endpoint was a composite of sustained ventricular arrhythmia, appropriate ICD-therapy, hospitalization for arrhythmia or heart-failure or all-cause mortality. Safety outcomes included death and electrolyte\/renal disturbances.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After six months, plasma potassium increased from 4.12 to 4.27 mmol\/L (p=0.004) with MRA, from 3.99 to 4.24 mmol\/L (p&amp;lt;0.001) with potassium-supplements, and from 3.98 to 4.34 mmol\/L (p&amp;lt;0.001) with combination-therapy. The primary endpoint occurred in 29% (n=175) of controls, 22% (n=16) in the MRA group, 21% (n=31) in the potassium-supplements group and in 22% (n=72) in the combination-therapy group (p=0.8 between regimens). Hypokalemia occurred in 13% of controls and in 3%, 9%, and 5% of participants receiving MRA, potassium-supplements and combination-therapy, respectively. Hyperkalemia occurred in 0.2% of controls and in 0%, 3%, and 4% of participants receiving MRA, potassium-supplements, and combination-therapy (p&amp;gt;0.1 between regimens).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euag272","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:21:39Z","timestamp":1791199299000},"source":"Crossref","is-referenced-by-count":0,"title":["Potassium-Increasing Regimens in Patients at High Risk of Ventricular Arrhythmias: A Prespecified Observational Analysis of the Randomized POTCAST Trial"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6967-4577","authenticated-orcid":false,"given":"Elisabeth Margrethe","family":"Danielsen","sequence":"first","affiliation":[{"name":"Department of Cardiology, The Heart Centre, Copenhagen University Hospital - Rigshospitalet , Blegdamsvej 9, 2100 Copenhagen \u00d8 ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8206-7011","authenticated-orcid":false,"given":"Emil Anton","family":"Frandsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Heart Centre, Copenhagen University Hospital - Rigshospitalet , Blegdamsvej 9, 2100 Copenhagen \u00d8 ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2165-9555","authenticated-orcid":false,"given":"Ulrik Christian Gudbrand","family":"Winsl\u00f8w","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Heart Centre, Copenhagen University Hospital - Rigshospitalet , Blegdamsvej 9, 2100 Copenhagen \u00d8 ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3248-8560","authenticated-orcid":false,"given":"Chaoqun","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Heart Centre, Copenhagen University Hospital - Rigshospitalet , Blegdamsvej 9, 2100 Copenhagen \u00d8 ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0665-9830","authenticated-orcid":false,"given":"Tharsika","family":"Sakthivel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Heart Centre, Copenhagen University Hospital - Rigshospitalet , Blegdamsvej 9, 2100 Copenhagen \u00d8 ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0504-8487","authenticated-orcid":false,"given":"Kasper Karmark","family":"Iversen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte , Herlev Ringvej 75, 2730 Herlev ,","place":["Denmark"]},{"name":"Department of Clinical Medicine, University of Copenhagen , Blegdamsvej 3B, 2200 Copenhagen N ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helle","family":"Skovmand Bosselmann","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Zealand University Hospital - Roskilde , Sygehusvej 10, 4000 Roskilde ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0357-9164","authenticated-orcid":false,"given":"Niels","family":"Risum","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Heart Centre, Copenhagen University Hospital - Rigshospitalet , Blegdamsvej 9, 2100 Copenhagen \u00d8 ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henning","family":"Bundgaard","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Heart Centre, Copenhagen University Hospital - Rigshospitalet , Blegdamsvej 9, 2100 Copenhagen \u00d8 ,","place":["Denmark"]},{"name":"Department of Clinical Medicine, University of Copenhagen , Blegdamsvej 3B, 2200 Copenhagen N ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1876-2623","authenticated-orcid":false,"given":"Christian","family":"J\u00f8ns","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Heart Centre, Copenhagen University Hospital - Rigshospitalet , Blegdamsvej 9, 2100 Copenhagen \u00d8 ,","place":["Denmark"]},{"name":"Department of Clinical Medicine, University of Copenhagen , Blegdamsvej 3B, 2200 Copenhagen N ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,6]]},"container-title":["Europace"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/europace\/advance-article-pdf\/doi\/10.1093\/europace\/euag272\/71619938\/euag272.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/europace\/advance-article-pdf\/doi\/10.1093\/europace\/euag272\/71619938\/euag272.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:06:42Z","timestamp":1791274002000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/europace\/advance-article\/doi\/10.1093\/europace\/euag272\/8868261"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/europace\/euag272","relation":{},"ISSN":["1099-5129","1532-2092"],"issn-type":[{"value":"1099-5129","type":"print"},{"value":"1532-2092","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]},"article-number":"euag272"}}