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Published on: May 28, 2019
Variations in Post-Operative Electrolyte in Coronary Artery Intervention
Qian Fan1, Zhongmei Bai2, Fabrice Yves Ndjana Lessomo3
1Department of Cardiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong Province, People's Republic of China.
Insights
Coronary angiography can cause electrolyte changes, particularly hypokalemia, in 15% of patients. Male patients are at higher risk, necessitating careful monitoring post-intervention to prevent complications.
Area of Science:
- Cardiology
- Clinical Chemistry
Background:
- Coronary interventions are often associated with overlooked electrolyte level changes.
- Limited research exists on post-coronary intervention electrolyte disturbances.
- This study aims to investigate the impact of coronary angiography on electrolyte levels.
Purpose of the Study:
- To analyze the effect of coronary angiography on pre- and post-intervention electrolyte levels.
- To identify patient groups at higher risk for electrolyte disturbances.
- To assess the correlation between electrolyte changes and clinical factors.
Main Methods:
- Analysis of pre- and post-intervention serum electrolytes (Na+, K+, Cl-, Mg2+) and renal function in 374 patients.
- Assessment of correlations between influential factors and electrolyte changes.
- Evaluation of hypokalemia association with major adverse cardiac events (MACE) and arrhythmia.
Main Results:
- A decrease in potassium levels was observed in 81.8% of patients, with 15.0% experiencing post-interventional hypokalemia.
- Male patients showed a 2.18 times higher incidence of hypokalemia compared to females.
- Hypokalemia was associated with hypertension, diabetes, and gastrointestinal disease, and increased arrhythmia risk.
Conclusions:
- Male patients are more susceptible to electrolyte disturbances after coronary intervention.
- Peri-operative electrolyte monitoring and management are crucial to prevent severe complications.
- Further research is needed to understand the mechanisms and long-term implications.
Background:
Low volume change and minimal trauma observed during angiography are the reason why physicians often overlook any changes affecting pre-operative electrolytes levels after coronary intervention. However, few studies have addressed the issue of electrolyte changes after the coronary intervention. Therefore, our study investigates coronary angiography's effect on electrolytes and provides the quick identification of groups more prone to electrolyte changes.
Methods:
From the department of cardiology of the second affiliated hospital of Shandong's first medical university, 374 patients undergoing coronary angiography were selected. Pre-intervention and post-intervention serums, sodium (Na+), potassium (K+), chloride (Cl-), magnesium (Mg2+) and renal function were analyzed. The correlation between influential factors was also assessed. The association of hypokalemia with short-major adverse cardiac events (MACE) and arrhythmia was evaluated.
Results:
Among the 374 subjects including 264 patients who had a simple angiography and 110 patients who received coronary artery interventional therapy. A decrease in potassium levels was found in 81.8% of the patients, and post-interventional hypokalemia was observed in 15.0%. After the intervention, the hypokalemia among males was 2.18 times than that of females, and the pre-operative serum potassium level was 3.5mmol/L≤K+<4.0mmol/L and was 2.09 times than that of K+≥4.0 mmol/L, but was not associated with age and either simple coronary angiography or PCI (percutaneous coronary intervention). Hypernatremia was also prevalent in males under 60 years and with pre-operative hypernatremia. Significant variations were found between hypokalemia and influential factors like hypertension, diabetes, and gastrointestinal disease. We also found that there was no obvious correlation between hypokalemia and recurrent angina, heart failure and death, but significantly increased the risk of some arrhythmias.
Conclusion:
Male patients are more likely to suffer from electrolyte disturbance after coronary intervention. There is a need to emphasize monitoring and managing electrolyte changes to prevent severe complications in the peri-operative period.
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