Acute coronary syndrome: potassium, magnesium and cardiac arrhythmia.
BACKGROUND
Cardiac arrhythmia is often present in patients with acute coronary syndrome (ACS) and may be due to the electrolyte imbalance.


OBJECTIVE
To assess the prevalence and clinical significance of electrolyte imbalance in ACS.


METHODS
Serum potassium and magnesium levels were measured within the first few hours in 204 consecutive patients with ACS admitted to our department over a period of 23 months. Cardiac arrhythmia was documented using continuous ECG monitoring, telemetry or standard ECG.


RESULTS
Hypokalemia was observed in 34% of patients, and was significantly associated with the occurrence of life-threatening ventricular arrhythmias (26% of patients with potassium level <4 mmol/l vs 11.9% of patients with normokalemia, p<0.001). No relationship was found between potassium level and supraventricular arrhythmias or in-hospital mortality. Decreased magnesium serum concentration was found in 22% of patients but was not significantly associated with cardiac arrhythmias or mortality.


CONCLUSIONS
Hypokalemia and hypomagnesemia are often present in patients with ACS. The former is associated with dangerous ventricular arrhythmias. Early assessment of electrolyte serum concentration is needed in order to implement proper supplementation.
Maciejewski
Paweł
P
Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland.
Bednarz
Bronisław
B
Chamiec
Tomasz
T
Górecki
Aleksander
A
Łukaszewicz
Rafał
R
Ceremuzyński
Leszek
L
D000208:Acute Disease; D000368:Aged; D001281:Atrial Fibrillation / Q000139:chemically induced; D003327:Coronary Disease / Q000150:complications* / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008274:Magnesium / Q000009:adverse effects* / Q000097:blood*; D008297:Male; D011188:Potassium / Q000009:adverse effects* / Q000097:blood*; D015995:Prevalence; D013577:Syndrome; D013610:Tachycardia / Q000139:chemically induced* / Q000503:physiopathology; D013617:Tachycardia, Supraventricular / Q000139:chemically induced; D017180:Tachycardia, Ventricular / Q000139:chemically induced; D014693:Ventricular Fibrillation / Q000139:chemically induced* / Q000503:physiopathology
D008274:Magnesium; D011188:Potassium