Physicians' Academy for Cardiovascular Education
Maintenance of lower potassium levels in HFrEF with potassium binder

Maintenance of lower potassium levels in HFrEF with potassium binder

News - May 24, 2022

Patiromer For The Management Of Hyperkalemia In Subjects Receiving RAAS-Inhibitors For Heart Failure With Reduced Ejection Fraction: Results From The DIAMOND Trial

Presented at ESC Heart Failure 2022 by Prof. Stefan Anker, MD, PhD (Berlin, Germany)

Introduction and methods

The DIAMOND trial enrolled HFrEF patients who had hyperkalemia on RAASi therapy or had a history of hyperkalemia due to RAASi therapy that resulted in downregulation of RAASi. First, 1195 patients entered the run-in phase, in which they were optimized on RAASi therapy, defined as requiring ≥50% doses of ACEi/ARB/ARNI and ≥50 mg dose of MRA, with the use of patiromer. 878 Patients that achieved optimized therapy were randomized to continuation of patiromer (n=439) or to withdrawal of patiromer and switched to placebo (n=439) in a double-blinded fashion.

When the trial was designed, the primary endpoint was determined as time to CV death or first CV hospitalization. But because of COVID-related issues, the primary endpoint was changed to the adjusted mean change in serum potassium levels at the end of the study.

End of study was in June 2021, average duration of follow-up was 266.6 days.



Use of patiromer resulted in maintenance of lower levels of potassium in patients with HFrEF who were optimized on RAASi therapy, and reduced the risk of hyperkalemia, and enabled guideline-recommended RAASi therapy.

– Our coverage of ESC Heart Failure 2022 is based on the information provided during the congress –

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