Clinical & Experimental Cardiology
Open Access
ISSN: 2155-9880
ISSN: 2155-9880
Ygal Plakht, Harel Gilutz and Arthur Shiyovich
Ben-Gurion University of the Negev, Israel
Beilinson Hospital, Israel
Scientific Tracks Abstracts: J Clin Exp Cardiolog
Background: Serum potassium levels (K, mEq/L) of patients with acute myocardial infarction (AMI) were found to be associated with short- and long-term outcomes. Nevertheless, significant fluctuations in K have been reported during the acute phase of an AMI. Aims: To evaluate the association between K changes during the hospitalization and in-hospital mortality of patients admitted with AMI. Methods: AMI patients hospitalized in a tertiary medical center, between 2002 and 2012, for 3 days or longer, were studied. Based on K levels during the hospitalization, the following parameters were calculated: minimal, maximal, range (maximal-minimal) and fluctuation (the gap between two consecutive K levels). The latter parameters were calculated for every K throughout the hospitalization. The associations between the parameters and outcome were assessed using generalized estimating equations model, adjusted to baseline patientsâ�?�? characteristics and results of other routine laboratory tests (i.e. Sodium, Creatinine and Glucose). Results: Overall 16,596 admissions of 12,176 patients were included (age 67.8�?±13.9 years, 66.6% males) and 111,457 K results registered. Overall, patients discharged alive from 15,564 admissions, with an in-hospital mortality rate of 6.2%. Compared with survivors, in-hospital mortalities had higher mean K (4.4�?±0.8 vs. 4.3�?±0.6), higher rate of fluctuation or range â�?¥0.4 (p<0.001 for each). Minimal K throughout the first 48 hours was significantly more prevalent among survivors compared to deceased (41% vs. 25% p<0.001). In a multivariate analysis the following parameters were found to be independent prognostic marker for mortality: K<3.9 (adjOR=1.22) or K>4.8 (adjOR=1.17), range â�?¥0.8 (adjOR=1.53) and minimal K during the first 2 days of admission (adjOR=1.49). Furthermore K fluctuation â�?¥0.4 was associated with increased mortality within the following 72 hours (adjOR=1.37), (p<0.001 for each). Conclusions: Changes in K, in addition to extreme values throughout an admission of AMI patients are strong prognostic markers of in-hospital mortality. Close monitoring of K in addition to further evaluation of mechanisms and interventions in K are in order.
Email: plakht@bgu.ac.il