Potassium variability during hospitalization and outcomes after discharge in patients with acute myocardial infarction

Xi-Ling ZHANG; Heng-Xuan CAI; Shan-Jie WANG; Xiao-Yuan ZHANG; Xin-Ran HAO; Shao-Hong FANG; Xue-Qin GAO; Bo YU

doi:10.11909/j.issn.1671-5411.2021.01.004

Volume 18 Issue 1

Feb. 2021

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Article Navigation > Journal of Geriatric Cardiology > 2021 > 18(1): 10-19

Please cite this article as: ZHANG XL, CAI HX, WANG SJ, ZHANG XY, HAO XR, FANG SH, GAO XQ, YU B. Potassium variability during hospitalization and outcomes after discharge in patients with acute myocardial infarction. J Geriatr Cardiol 2021; 18(1): 10−19. DOI: 10.11909/j.issn.1671-5411.2021.01.004

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Please cite this article as: ZHANG XL, CAI HX, WANG SJ, ZHANG XY, HAO XR, FANG SH, GAO XQ, YU B. Potassium variability during hospitalization and outcomes after discharge in patients with acute myocardial infarction. J Geriatr Cardiol 2021; 18(1): 10−19. DOI: 10.11909/j.issn.1671-5411.2021.01.004

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Potassium variability during hospitalization and outcomes after discharge in patients with acute myocardial infarction

doi: 10.11909/j.issn.1671-5411.2021.01.004

Xi-Ling ZHANG^{1, 2, *},
Heng-Xuan CAI^{1, 2, *},
Shan-Jie WANG^{1, 2},
Xiao-Yuan ZHANG^{1, 2},
Xin-Ran HAO^{2, 3},
Shao-Hong FANG^{1, 2},
Xue-Qin GAO^{1, 2
,
,},
Bo YU^{1, 2
,
,}

1.
Department of Cardiology, Second Afﬁliated Hospital of Harbin Medical University, Harbin, China
2.
The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Nangang District, Harbin, China
3.
Department of Neurobiology, Neurobiology Key Laboratory, Harbin Medical University, Education Department of Heilongjiang Province, Harbin, China

More Information

Corresponding author: xueqin211@126.com; dryu_hmu@163.com
Available Online: 2021-02-07
Publish Date: 2021-01-28

Abstract

Abstract

BACKGROUND The variability of metabolic biomarkers has been determined to provide incremental prognosis information, but the implications of electrolyte variability remained unclear. METHODS We investigate the relationships between electrolyte fluctuation and outcomes in survivors of acute myocardial infarction (n = 4386). Ion variability was calculated as the coefficient of variation, standard deviation, variability independent of the mean (VIM) and range. Hazard ratios (HR) were estimated using the multivariable-adjusted Cox proportional regression method. RESULTS During a median follow-up of 12 months, 161 (3.7%) patients died, and heart failure occurred in 550 (12.5%) participants after discharge, respectively. Compared with the bottom quartile, the highest quartile potassium VIM was associated with increased risks of all-cause mortality (HR = 2.35, 95% CI: 1.36–4.06) and heart failure (HR = 1.32, 95% CI: 1.01–1.72) independent of cardiac troponin I (cTnI), N terminal pro B type natriuretic peptide (NT-proBNP), infarction site, mean potassium and other traditional factors, while those associations across sodium VIM quartiles were insignificant. Similar trend remains across the strata of variability by other three indices. These associations were consistent after excluding patients with any extreme electrolyte value and diuretic use. CONCLUSIONS Higher potassium variability but not sodium variability was associated with adverse outcomes post-infarction. Our findings highlight that potassium variability remains a robust risk factor for mortality regardless of clinical dysnatraemia and dyskalaemia.

^*The authors contributed equally to this manuscript

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References(30)

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