Relation of Serum Potassium Level to Long-Term Outcomes in Patients With Acute Myocardial Infarction

Choi, Joon Seok; Kim, Young A; Kim, Ha Yeon; Oak, Chan Young; Kang, Yong Un; Kim, Chang Seong; Bae, Eun Hui; Kwon, Seong; Ahn, Young Keun; Jeong, Myung Ho; Kim, Soo Wan

doi:10.1016/j.amjcard.2014.01.402

Cited by 44 publications

(90 citation statements)

References 17 publications

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“…We compared the clinical characteristics of hospital survivors and non-survivors, and found that some of laboratory tests were associated with hospital outcomes, such as RDW and potassium. These findings are partially consistent with previous reports (4)(5)(6)(7)(8)(9)(10)(11). However, we noted that percentages of basophil and eosinophil were decreased in hospital non-survivors, suggesting that eosinophil and basophil percentages are potential prognostic factors for AMI and thus unmasking a potential (new) of these blood cells in the complications of acute coronary syndrome.…”

Section: Discussionsupporting

confidence: 82%

“…For example, higher red blood cell distribution width (RDW) (4), neutrophil to lymphocyte ratio (5), mean corpuscular volume (MCV) (6), platelet count (7) and white blood cell (WBC) (8) count are associated with poorer outcomes in patients with acute myocardial infarction (AMI), while decreased Focus on State of the Art in Diagnostics of the Acute Coronary Syndrome hemoglobin is associated with higher mortality (9). In addition, serum potassium level can also impact the outcomes of AMI patients (10,11). Since these routine laboratory tests are usually mutually correlated (e.g., WBC and RDW (12), RDW and hemoglobin (12), platelet count and potassium (13), platelet count and RDW (14), neutrophil count and RDW (15), the confounding effects of another tests cannot thus be ignored when the prognostic value of an interesting test is evaluated.…”

Section: Introductionmentioning

confidence: 99%

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Lower mean corpuscular hemoglobin concentration is associated with poorer outcomes in intensive care unit admitted patients with acute myocardial infarction

Huang¹,

Hu²

2016

Annals of Translational Medicine

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Background: Accumulated studies have shown that hematological parameters [e.g., red blood cell distribution width (RDW), hemoglobin, platelet count] and serum potassium level can impact the prognosis of patients with acute myocardial infarction (AMI). However, no previous study has evaluated the prognostic values of these laboratory tests simultaneously.Methods: This study is based on an intensive care unit (ICU) database named Multiparameter Intelligent Monitoring in Intensive Care II (MIMIC II). Adult patients with AMI were included, and their hematological parameters and serum ion levels on admission were extracted. The relationships between these laboratory tests and hospital mortality were evaluated using a logistic regression model and receiver operating characteristic (ROC) curve analysis. The effects of these laboratory tests on 1-year mortality were evaluated using a Cox hazard regression model and Kaplan-Meier curve analysis.Results: In univariable analysis, increased white blood cell (WBC), neutrophil percentage, mean corpuscular volume (MCV), RDW, potassium and decreased red blood cell (RBC), hemoglobin, mean corpuscular hemoglobin concentration (MCHC), hematocrit and percentage of lymphocyte, monocyte, basophil and eosinophil were significantly associated with hospital mortality. In multivariable analyses, basophil percentage, potassium, WBC and MCHC were independently associated with hospital morality, while WBC, RDW, MCHC, potassium and percentages of neutrophil and lymphocyte were associated with 1-year mortality.Conclusions: Hematological parameters and serum potassium can provide prognostic information in AMI patients. MCHC is an independent prognostic factor for both short and long term outcomes of AMI.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Lower mean corpuscular hemoglobin concentration is associated with poorer outcomes in intensive care unit admitted patients with acute myocardial infarction

Huang¹,

Hu²

2016

Annals of Translational Medicine

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“…Two recent studies have reported a U-shaped relationship between serum potassium and in- hospital and long-term mortality in patients with acute myocardial infarction. 6,23 Both of these studies showed that serum potassium <3.5 or ≥4.5 mmol/l was associated with increased mortality and called into question clinical guidelines recommending serum potassium levels of 4.0-5.0 mmol/l. 3,4 A laboratory-based study found that a lower mortality rate was associated with a serum potassium of 3.4-4.3 mmol/l, however this study was not able to suffi ciently control for confounding factors.…”

Section: Discussionmentioning

confidence: 99%

Serum potassium levels as an outcome determinant in acute medical admissions

et al. 2015

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The relationship between serum potassium levels and mortality in acute medical admissions is uncertain. In particular, the relevance of minor abnormalities in potassium level or variations within the normal range remains to be determined. We performed a retrospective cohort study of all emergency medical admissions to St James's Hospital (Dublin, Ireland) between 2002 and 2012. We used a stepwise logistic regression model to predict in-hospital mortality, adjusting risk estimates for major predictor variables. There were 67,585 admissions in 37,828 patients over 11 years. After removing long-stay patients, 60,864 admissions in 35,168 patients were included in the study. Hypokalaemia was present in 14.5% and hyperkalaemia in 4.9%. In-hospital mortality was 3.9, 5.0, and 18.1% in the normokalaemic, hypokalaemic and hyperkalaemic groups respectively. Hypokalaemic patients had a univariate odds ratio (OR) of 1.29 for in-hospital mortality (95% confi dence interval (CI) 1.16-1.43; p<0.001). Hyperkalaemic patients had a univariate OR for in-hospital mortality of 5.2 (95% CI 4.7-5.7; p<0.001). The ORs for an in-hospital death for potassium between 4.3 and 4.7 mmol/l, and 4.7 and 5.2 mmol/l, were 1.73 (95% CI 1.51-1.99) and 2.97 (95% CI 2.53-3.50) respectively. Hyperkalaemia and hypokalaemia are associated with increased mortality.

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“…Our results were found to be in correlation with the results obtained by previous authors who have reported a male preponderance in AMI groups of their respective studies. 14,15 Hypokalemia was found in 24% cases, hyperkalemia in 6% and 70% were normokalemic. Our results were in correlation with the results obtained by studies of past literature, which have reported that prevalence of hypokalemia in AMI patients varies from 9 % to 25 %.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of prognostic role of serum potassium in patients with Acute Myocardial Infarction: A cross-sectional study from a tertiary hospital in northern India

Neki¹,

Kumar²,

Kaur³

et al. 2017

Int. J. Curr. Res. Biol. Med.

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Relation of Serum Potassium Level to Long-Term Outcomes in Patients With Acute Myocardial Infarction

Cited by 44 publications

References 17 publications

Lower mean corpuscular hemoglobin concentration is associated with poorer outcomes in intensive care unit admitted patients with acute myocardial infarction

Lower mean corpuscular hemoglobin concentration is associated with poorer outcomes in intensive care unit admitted patients with acute myocardial infarction

Serum potassium levels as an outcome determinant in acute medical admissions

Evaluation of prognostic role of serum potassium in patients with Acute Myocardial Infarction: A cross-sectional study from a tertiary hospital in northern India

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