The significance of metabolic alkalosis on acute decompensated heart failure: the ALCALOTIC study
verfasst von:
Joan Carles Trullàs, Ana Isabel Peláez, Julio Blázquez, Anna Sánchez-Biosca, Manuel Lorenzo López-Reborio, Prado Salamanca-Bautista, José María Fernández-Rodríguez, Miguel Ángel Vázquez-Ronda, Melitón Francisco Dávila-Ramos, Humberto Mendoza-Ruiz-De-Zuazu, José Luís Morales-Rull, Jesús Olmedo-Llanes, Pau Llàcer, Alicia Conde-Martel, on behalf of the ALCALOTIC study investigators
To determine the prevalence and the impact on prognosis of metabolic alkalosis (MA) in patients admitted for acute heart failure (AHF).
Methods and results
The ALCALOTIC is a multicenter, observational cohort study that prospectively included patients admitted for AHF. Patients were classified into four groups according to their acid–base status on admission: acidosis, MA, respiratory alkalosis, and normal pH (reference group for comparison). Primary endpoint was all-cause in-hospital mortality, and secondary endpoints included 30/90-day all-cause mortality, all-cause readmission, and readmission for HF. Associations between endpoints and acid–base alterations were estimated in a multivariate Cox regression model including sex, age, comorbidities, and Barthel index and expressed as hazard ratio (HR) with 95% confidence interval (95% CI). Six hundred sixty-five patients were included (84 years and 57% women), and 40% had acid–base alterations on admission: 188 (28%) acidosis and 78 (12%) alkalosis. The prevalence (95% CI) of MA was 9% (6.8–11.2%). Patients with MA were more women; had fewer comorbidities, better renal function, and higher left ventricle ejection fraction values; and received more treatment with oral acetazolamide during hospitalization and at discharge. MA was not associated with a higher risk of in-hospital mortality and 30/90-day all-cause mortality or readmissions but was associated with a significant increase in readmissions for HF at 30 and 90 days (adjusted HR [95% CI] 3.294 [1.397–7.767], p = 0.006 and 2.314 [1.075–4.978], p = 0.032).
Conclusion
The prevalence of MA in patients admitted for AHF was 9%, and its presence was associated with more readmissions for HF but not with all-cause mortality.
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The significance of metabolic alkalosis on acute decompensated heart failure: the ALCALOTIC study
verfasst von
Joan Carles Trullàs Ana Isabel Peláez Julio Blázquez Anna Sánchez-Biosca Manuel Lorenzo López-Reborio Prado Salamanca-Bautista José María Fernández-Rodríguez Miguel Ángel Vázquez-Ronda Melitón Francisco Dávila-Ramos Humberto Mendoza-Ruiz-De-Zuazu José Luís Morales-Rull Jesús Olmedo-Llanes Pau Llàcer Alicia Conde-Martel on behalf of the ALCALOTIC study investigators
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