{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T04:21:23Z","timestamp":1776054083528,"version":"3.50.1"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"31","license":[{"start":{"date-parts":[[2022,6,10]],"date-time":"2022-06-10T00:00:00Z","timestamp":1654819200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001003","name":"Boehringer Ingelheim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001003","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Eli Lilly","award":["NCT03057977"],"award-info":[{"award-number":["NCT03057977"]}]},{"name":"Eli Lilly","award":["NCT03057951"],"award-info":[{"award-number":["NCT03057951"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Hyperkalaemia frequently leads to interruption and discontinuation of neurohormonal antagonists, which may worsen heart failure prognosis. Some studies suggested that sodium-glucose cotransporter 2 inhibitors reduce hyperkalaemia, an effect that may have important clinical implications. This analysis evaluates the effect of empagliflozin on the occurrence of hyper- and hypokalaemia in HF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>EMPEROR-Pooled (i.e. EMPEROR-Reduced and EMPEROR-Preserved combined) included 9583 patients with available serum potassium levels at baseline (98.6% of the total EMPEROR-Pooled population, n\u2009=\u20099718). Hyperkalaemia was identified by investigators\u2019 reports of adverse events, and by a laboratory serum potassium value above 5.5\u2005mmol\/L and 6.0\u2005mmol\/L. The main outcome was a composite of investigator-reported hyperkalaemia or initiation of potassium binders. Patients with high potassium at baseline were more frequently diagnosed with diabetes and ischaemic HF aetiology and had lower left ventricular ejection fraction and estimated glomerular filtration rate but were more frequently treated with sacubitril\/valsartan or mineralocorticoid receptor antagonists. Empagliflozin (compared with placebo) reduced the composite of investigator-reported hyperkalaemia or initiation of potassium binders [6.5% vs. 7.7%, hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.71\u20130.95, P\u2009=\u20090.01]. Empagliflozin reduced hyperkalaemia rates regardless of the definition used (serum potassium &amp;gt;5.5\u2005mmol\/l: 8.6% vs. 9.9%, HR 0.85, 95% CI 0.74\u20130.97, P\u2009=\u20090.017; serum potassium &amp;gt;6.0\u2005mmol\/l: 1.9% vs. 2.9%, HR 0.62, 95% CI 0.48\u20130.81, P\u2009&amp;lt;\u20090.001). The incidence of hypokalaemia (investigator-reported or serum potassium &amp;lt;3.0\u2005mmol\/l) was not significantly increased with empagliflozin.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Empagliflozin reduced the incidence of hyperkalaemia without significant increase in hypokalaemia.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehac306","type":"journal-article","created":{"date-parts":[[2022,6,10]],"date-time":"2022-06-10T15:07:52Z","timestamp":1654873672000},"page":"2984-2993","source":"Crossref","is-referenced-by-count":83,"title":["Empagliflozin and serum potassium in heart failure: an analysis from EMPEROR-Pooled"],"prefix":"10.1093","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2304-6138","authenticated-orcid":false,"given":"Jo\u00e3o Pedro","family":"Ferreira","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Lorraine, Inserm, Centre d'Investigations Cliniques Plurith\u00e9matique 1433, and Inserm U1116, CHRU, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists) , Nancy , France"},{"name":"Cardiovascular Research and Development Center, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto , Porto , Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7456-1570","authenticated-orcid":false,"given":"Faiez","family":"Zannad","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine, Inserm, Centre d'Investigations Cliniques Plurith\u00e9matique 1433, and Inserm U1116, CHRU, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists) , Nancy , France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7683-4720","authenticated-orcid":false,"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"Baylor Heart and Vascular Institute Dallas , TX , USA"}]},{"given":"Gerasimos","family":"Filipattos","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens School of Medicine , Athens , Greece"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1940-2440","authenticated-orcid":false,"given":"Ivana","family":"Ritter","sequence":"additional","affiliation":[{"name":"Boehringer Ingelheim International GmbH , Ingelheim , Germany"}]},{"given":"Elke","family":"Sch\u00fcler","sequence":"additional","affiliation":[{"name":"mainanalytics GmbH , Sulzbach , Germany"}]},{"given":"Bettina J","family":"Kraus","sequence":"additional","affiliation":[{"name":"Boehringer Ingelheim International GmbH , Ingelheim , Germany"},{"name":"Department of Internal Medicine I, University Hospital W\u00fcrzburg , W\u00fcrzburg , Germany"},{"name":"Comprehensive Heart Failure Centre, University of W\u00fcrzburg , W\u00fcrzburg , Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2212-4007","authenticated-orcid":false,"given":"Stuart J","family":"Pocock","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine , London , UK"}]},{"given":"Stefan D","family":"Anker","sequence":"additional","affiliation":[{"name":"Department of Cardiology (CVK) Berlin Institute of Health Center for Regenerative Therapies (BCRT) German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charit\u00e9 Universit\u00e4tsmedizin Berlin , Berlin , Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1828-2387","authenticated-orcid":false,"given":"Milton","family":"Packer","sequence":"additional","affiliation":[{"name":"Baylor Heart and Vascular Institute Dallas , TX , USA"},{"name":"Imperial College , London , UK"}]}],"member":"286","published-online":{"date-parts":[[2022,6,10]]},"reference":[{"key":"2022081323573458400_ehac306-B1","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1056\/NEJMra035279","article-title":"Managing hyperkalemia caused by inhibitors of the renin-angiotensin-aldosterone system","volume":"351","author":"Palmer","year":"2004","journal-title":"N Engl J Med"},{"key":"2022081323573458400_ehac306-B2","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.2215\/CJN.08580813","article-title":"Regulation of potassium homeostasis","volume":"10","author":"Palmer","year":"2015","journal-title":"Clin J Am Soc Nephrol"},{"key":"2022081323573458400_ehac306-B3","doi-asserted-by":"crossref","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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