Baptist Health Hardin

Krishnan Challappa

Principal Investigator

Amy Steward

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Care HK: Cardiovascular and Renal Treatment in Heart Failure Patients with Hyperkalemia or at High Risk of Hyperkalemia
The CARE-HK in HF is a registry study based on the hypothesis that adherence to guidelines is associated with improved real-world outcomes for heart failure (HF) patients. For the purpose of this study, adherence to guidelines is defined as 1) adherence to potassium (sK+) monitoring recommendations, and 2) adherence to renin-angiotensin-aldosterone system inhibitor (RAASi) treatment recommendations, according to the most current local guidelines at the time of assessment.
The study aims to evaluate real-world RAASi treatment patterns in clinical practice compared with the guideline-directed medical therapy (GDMT) recommendations. Factors associated with patients achieving GDMT will be evaluated to identify potential barriers.
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Eligibility Criteria


  • Patient diagnosed with chronic HF ≥3 months prior to signature of informed consent.
  • Patient has at least 1 record of left ventricular ejection fraction (LVEF) documented in patient medical record in the 24 months prior to signature of informed consent.
  • Patient treated with angiotensin-converting enzyme inhibitors (ACEi) / angiotensin receptor blockers (ARB) / angiotensin receptor-neprilysin inhibitors (ARNi) at enrolment.
  • Patient treated with or a candidate for treatment with mineralcorticoid receptor antagonist (MRA) per a relevant treatment guideline at enrolment.
  • Patient at increased risk of hyperkalemia due to one or more of the following:
    • Current hyperkalemia (sK+ >5.0 mEq/L) at enrolment
    • Record of documented hyperkalemia (sK+ >5.0 mEq/l) in the 24 months prior to signature of informed consent
    • estimated glomerular filtration rate (eGFR) <45 mL/min/1.73m2, or Chronic Kidney Disease (CKD) stage ≥3b.
    • Patient judged by the Investigator to have sufficient cognitive ability to participate


  • Patient on renal replacement therapy or mechanical circulatory support.
  • Disease other than HF with expected survival <1 year.
  • Patient is participating in, or being screened for, an interventional trial.
  • Patient already found to be intolerant to MRA for reasons other than hyperkalemia or renal impairment.