The following is a summary of “Significance of metabolic alkalosis on acute decompensated heart failure: the ALCALOTIC study,” published in the May 2024 issue of Cardiology by Trullàs et al.

Researchers conducted a prospective study determining the prevalence of metabolic alkalosis (MA) and how it affects the outcomes of patients admitted for acute heart failure (AHF). 

They conducted the ALCALOTIC study, enrolling patients admitted for AHF and categorizing them based on their acid–base status on admission: acidosis, MA, respiratory alkalosis, and normal pH. The primary endpoint of this study was to determine all-cause in-hospital mortality, and the Cox regression model was used to assess the secondary endpoints, which were 30/90 day associations with mortality and readmissions, adjusting for demographics, comorbidities, and functional status.

The results showed that 665 patients with AHF were included (average age 84; 57% women), with 40% showing acid-base alterations on admission, 188 (28%) acidosis, and 78 (12%) alkalosis. The prevalence of MA was 9% (6.8%-11.2%). Patients with MA were more likely women with fewer comorbidities, better kidney function, and higher left ventricular ejection fraction values. These women also received more treatment with oral acetazolamide during hospitalization and at discharge. MA was linked to increased HF readmissions at 30 and 90 days (3.294 [1.397-7.767], P=0.006 and 2.314 [1.075-4.978], P=0.032) but not to higher mortality. 

Investigators concluded that MA was linked to higher readmission rates for heart failure. However, it did not increase the risk of overall mortality in patients.

Source: link.springer.com/article/10.1007/s00392-024-02452-z