Admission serum potassium concentration and long-term mortality in patients with acute myocardial infarction: results from the MONICA-KORA myocardial infarction registryReportar como inadecuado




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BMC Cardiovascular Disorders

, 17:198

Coronary artery disease

Abstract

BackgroundConflicting with clinical practice guidelines, recent studies demonstrated that serum potassium concentrations SPC of ≥4.5 mEq-l were associated with increased mortality in patients with acute myocardial infarction AMI. This study examined the association between SPC and long-term mortality following AMI in patients recruited from a population-based registry.

MethodsIncluded in the study were 3347 patients with AMI aged 28–74 years consecutively hospitalized between 1 January 2000 and 31 December 2008 and followed up until 31 December 2011. Patients were categorized into five SPC groups <3.5, 3.5 to <4.0, 4.0 to <4.5, 4.5 to <5.0, and ≥5.0 mEq-l. The outcome of the study was all-cause mortality. Cox regression models adjusted for risk factors, co-morbidities and in-hospital treatment were constructed.

ResultsIn our study population, 249 patients 7.4% had a low SPC <3.5 mEq-l and 134 4.0% patients had a high SPC ≥5.0 mEq-l. Patients with SPC of ≥5.0 mEq-l had the highest long-term mortality 29.9% and in the adjusted model, their risk of dying was significantly increased HR 1.46, 95% CI 1.03 to 2.07 compared to patients with SPC between 4.0 and <4.5 mEq-l. Analyses of increasing observation periods showed a trend towards a higher risk of dying in patients with SPC between 4.5 and <5.0 mEq-l.

ConclusionAn admission SPC of ≥5.0 mEq-l might be associated with an increased mortality risk in patients with AMI. Patients with an admission SPC between 4.5 and <5.0 mEq-l might have an increased mortality risk in the first few years following AMI.

KeywordsMyocardial Infarction Potassium Hypokalemia Hyperkalemia Mortality AbbreviationsACEIAngiotensin-converting enzyme inhibitor

AMIAcute myocardial infarction

ANOVAAnalysis of variance

ARBAngiotensin-receptor blockers

CK-MBCreatine kinase-myocardial band

EBMEvidence-based medication

eGFREstimated glomerular filtration rate

HRHazard ratio

IQRInterquartile range

KORACooperative Health Research in the Region of Augsburg

LVEFLeft ventricular ejection fraction

MDRDModification of Diet in Renal Disease

MIMyocardial infarction

MONICAMonitoring Trends and Determinants in Cardiovascular disease

PCIPercutaneous coronary intervention

SDStandard deviation

SPCSerum potassium concentration

VIFVariance inflation factor

WHOWorld Health Organization

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Autor: Miriam Giovanna Colombo - Inge Kirchberger - Ute Amann - Margit Heier - Christian Thilo - Bernhard Kuch - Annette Peters -

Fuente: https://link.springer.com/







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