Effect of Dynamic Potassium Change on In-Hospital Mortality, Ventricular Arrhythmias, and Long-Term Mortality in...

Area of Science:

• Cardiology
• Clinical Medicine
• Biochemistry

Background:

• Serum potassium (K) levels are critical for cardiac function.
• Maintaining normal potassium levels is essential post-myocardial infarction.
• Deviations from normal potassium ranges can impact patient outcomes.

Purpose of the Study:

• To evaluate the impact of serum potassium deviation on clinical outcomes in ST-segment elevation myocardial infarction (STEMI) patients initially normokalemic.
• To compare in-hospital and long-term mortality and ventricular arrhythmia rates based on potassium level changes.

Main Methods:

• Retrospective analysis of 2773 STEMI patients with admission serum K of 3.5-4.5 mEq/L.
• Patients categorized into normokalemia-to-hypokalemia, normokalemia-to-normokalemia, and normokalemia-to-hyperkalemia groups.
• Hierarchical multivariable and Cox regression analyses used to assess mortality and arrhythmia risks.

Main Results:

• In-hospital mortality risk was significantly higher in both the normokalemia-to-hypokalemia (OR 3.03) and normokalemia-to-hyperkalemia (OR 2.81) groups compared to the normokalemia-to-normokalemia group.
• Long-term mortality risk was also elevated in the normokalemia-to-hypokalemia (HR 3.78) and normokalemia-to-hyperkalemia (HR 2.97) groups.
• Ventricular arrhythmia risk increased in the normokalemia-to-hypokalemia group (OR 2.98).

Conclusions:

• Deviation of serum potassium levels from normal ranges post-STEMI is associated with adverse clinical outcomes.
• Both hypokalemia and hyperkalemia following an initial normokalemic state increase mortality and arrhythmia risks.
• Close monitoring and management of serum potassium levels are crucial for STEMI patients.