{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T12:31:31Z","timestamp":1784550691474,"version":"3.55.0"},"reference-count":20,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T00:00:00Z","timestamp":1645488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"AstraZeneca Farmac\u00e9utica, Spain, S.A.","award":["ESR-17-13244"],"award-info":[{"award-number":["ESR-17-13244"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Hyperkalaemia is a growing concern in the treatment of patients with heart failure and reduced ejection fraction (HFrEF) as it limits the use of some prognostic-modifying drugs and has a negative impact on prognosis. The objective of the present study was to estimate the prevalence of hyperkalaemia in outpatients with HFrEF and its impact on achieving optimal medical treatment. For this purpose, a multicentre, prospective, and observational study was carried out on consecutive HFrEF patients who were monitored as outpatients in heart failure (HF) units and who, in the opinion of their doctor, received optimal medical treatment. A total of 565 HFrEF patients were included from 16 specialised HF units. The mean age was 66 \u00b1 12 years, 78% were male, 45% had an ischemic cause, 39% had atrial fibrillation, 43% were diabetic, 42% had a glomerular filtration rate &lt; 60 mL\/min\/1.7 m2, and the mean left ventricular ejection fraction was 31 \u00b1 7%. Treatment at the study entry included: 76% on diuretics, 13% on ivabradine, 7% on digoxin, 18.9% on angiotensin-conversing enzyme inhibitors (ACEi), 11.3% on angiotensin receptors blockers (ARBs), 63.8% on angiotensin-neprilysin inhibitors (ARNi), 78.5% on mineralocorticoid receptor antagonists (MRAs), and 92.9% on beta-blockers. Potassium levels in the baseline analysis were: \u22645 mEq\/L = 80.5%, 5.1\u20135.4 mEq\/L = 13.8%, 5.5\u20135.9 mEq\/L = 4.6%, and \u22656 mEq\/L = 1.06%. Hyperkalaemia was the reason for not prescribing or reaching the target dose of an MRAs in 34.8% and 12.5% of patients, respectively. The impact of hyperkalaemia on not prescribing or dropping below the target dose in relation to ACEi, ARBs, and ARNi was significantly less. In conclusion, hyperkalaemia is a frequent problem in the management of patients with HFrEF and a limiting factor in the optimisation of medical treatment.<\/jats:p>","DOI":"10.3390\/jcm11051170","type":"journal-article","created":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T22:34:30Z","timestamp":1645569270000},"page":"1170","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Prevalence, Incidence, and Outcomes of Hyperkalaemia in Patients with Chronic Heart Failure and Reduced Ejection Fraction from a Spanish Multicentre Study: SPANIK-HF Design and Baseline Characteristics"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5401-8324","authenticated-orcid":false,"given":"Juan F.","family":"Delgado-Jim\u00e9nez","sequence":"first","affiliation":[{"name":"Instituto de Investigaci\u00f3n y Servicio de Cardiolog\u00eda del Hospital Universitario 12 de Octubre, 28041 Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4606-3416","authenticated-orcid":false,"given":"Javier","family":"Segovia-Cubero","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain"},{"name":"Servicio de Cardiolog\u00eda, Hospital Universitario Puerta de Hierro, 28222 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7710-361X","authenticated-orcid":false,"given":"Luis","family":"Almenar-Bonet","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain"},{"name":"Servicio de Cardiolog\u00eda, Hospital Universitario La Fe, 46026 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9847-687X","authenticated-orcid":false,"given":"Javier","family":"de Juan-Bagud\u00e1","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n y Servicio de Cardiolog\u00eda del Hospital Universitario 12 de Octubre, 28041 Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Lara-Padr\u00f3n","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Hospital Universitario de Canarias, 38320 Santa Cruz de Tenerife, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5999-5741","authenticated-orcid":false,"given":"Jos\u00e9 Manuel","family":"Garc\u00eda-Pinilla","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain"},{"name":"Servicio de Cardiolog\u00eda, International Business Information Management Association, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Luis","family":"Bonilla-Palomas","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Hospital San Juan de la Cruz, \u00dabeda, 23400 Jaen, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"L\u00f3pez-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5955-2748","authenticated-orcid":false,"given":"Sonia","family":"Mirabet-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain"},{"name":"Servicio de Cardiolog\u00eda, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In\u00e9s","family":"G\u00f3mez-Otero","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain"},{"name":"Servicio de Cardiolog\u00eda, Complexo Hospitalario Universitario de Santiago de Compostela, 15706 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Castro-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Hospital Universitario Virgen de la Macarena, 41009 Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7773-8121","authenticated-orcid":false,"given":"Beatriz","family":"D\u00edaz-Molina","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain"},{"name":"Servicio de Cardiolog\u00eda, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josebe","family":"Goirigolzarri-Artaza","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain"},{"name":"Servicio de Cardiolog\u00eda, Hospital Universitario Cl\u00ednico de San Carlos, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1819-5742","authenticated-orcid":false,"given":"Luis Miguel","family":"Rinc\u00f3n-D\u00edaz","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain"},{"name":"Servicio de Cardiolog\u00eda, Hospital Ram\u00f3n y Cajal, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4993-9540","authenticated-orcid":false,"given":"Domingo Andr\u00e9s","family":"Pascual-Figal","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain"},{"name":"Servicio de Cardiolog\u00eda, Hospital Cl\u00ednico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Anguita-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Hospital Universitario Reina Sof\u00eda, 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Mu\u00f1iz","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a, Universidade da Coru\u00f1a (UDC), 15006 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda G.","family":"Crespo-Leiro","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain"},{"name":"Servicio de Cardiolog\u00eda, Complexo Hospitalario Universitario, 15006 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,22]]},"reference":[{"key":"ref_1","first-page":"31","article-title":"Epidemiology and Treatment of Heart Failure in Spain: The HF-PATHWAYS Study","volume":"75","author":"Palacios","year":"2020","journal-title":"Rev. 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Heart Fail."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/5\/1170\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:24:51Z","timestamp":1760135091000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/5\/1170"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,22]]},"references-count":20,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["jcm11051170"],"URL":"https:\/\/doi.org\/10.3390\/jcm11051170","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,22]]}}}