1. Serum Potassium Levels and Short-Term Outcomes in Patients With ST-Segment Elevation Myocardial Infarction.
- Author
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Ma, Wenfang, Liang, Yan, Zhu, Jun, Yang, Yanmin, Tan, Huiqiong, Yu, Litian, Gao, Xin, Feng, Guangxun, and Li, Jiandong
- Subjects
ARRHYTHMIA ,CHI-squared test ,STATISTICAL correlation ,ELECTROCARDIOGRAPHY ,FISHER exact test ,HOSPITALS ,MEDICAL protocols ,MYOCARDIAL infarction ,POTASSIUM ,TIME ,ACQUISITION of data ,PROPORTIONAL hazards models ,RETROSPECTIVE studies ,DATA analysis software ,LOG-rank test ,KRUSKAL-Wallis Test - Abstract
Current guidelines recommend maintaining serum potassium levels between 4.0 and 5.0 mEq/L (1 mEq/L = mmol/L) in patients with acute myocardial infarction. However, these guidelines are based on studies conducted before the β blocker and reperfusion era. We retrospectively analyzed 6613 patients diagnosed with ST-segment elevation myocardial infarction (STEMI) who presented without renal insufficiency. Patients were categorized into 5 groups according to mean serum potassium levels: <3.5, 3.5 to <4.0, 4.0 to <4.5, 4.5 to <5.0, and ≥5.0 mEq/L. Patients with potassium levels of 4.0 to <4.5 mEq/L had the lowest predefined event rates, which were 6.4% for 7-day malignant arrhythmia, 3.7% for 7-day mortality, and 5.3% for 30-day mortality. Compared with the reference group (4.0 to <4.5 mEq/L), multivariate regression analysis revealed significantly higher 30-day mortality risk in patients with potassium level of 4.5 to <5.0 (hazard ratio [HR]: 1.52, 95% confidence interval [CI]: 1.17-1.98; P = .002) and even higher risk in patients with potassium level of ≥5.0 mEq/L (HR: 1.80, 95% CI: 1.22-2.66; P = .002). The lowest 30-day mortality was observed in patients with STEMI having potassium levels between 4.0 and 4.5 mEq/L, and a level >4.5 mEq/L significantly increased mortality risk. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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