title: Relation of serum potassium level to long-term outcomes in patients with acute myocardial infarction.
abstract: Potassium plays a key role in normal myocardial function, and current guidelines recommend that serum potassium levels be maintained from 4.0 to 5.0 mEq/L in patients with acute myocardial infarction (AMI). However, the impact of serum potassium levels on long-term mortality has not been evaluated. We retrospectively studied 1,924 patients diagnosed with AMI. The average serum potassium levels measured throughout the hospitalization were obtained and statistically analyzed. Patients were categorized into 5 groups to determine the relation between mean serum potassium and long-term mortality: <3.5, 3.5 to <4.0, 4.0 to <4.5, 4.5 to <5.0, and ≥5 mEq/L. The long-term mortality was lowest in the group of patients with potassium levels of 3.5 to <4.0 mEq/L, whereas mortality was higher in the patients with potassium levels≥4.5 or <3.5 mEq/L. In a multivariate Cox-proportional regression analysis, the mortality risk was greater for serum potassium levels of >4.5 mEq/L (hazard ratio [HR] 1.71, 95% confidence interval [CI] 1.04 to 2.81 and HR 4.78, 95% CI 2.14 to 10.69, for patients with potassium levels of 4.5 to <5.0 mEq/L and ≥5.0, respectively) compared with patients with potassium levels of 3.5 to <4.0 mEq/L. The mortality risk was also higher for patients with potassium levels<3.5 mEq/L (HR 1.55, 95% CI 0.94 to 2.56). In contrast to the association with long-term mortality, there was no relation between serum potassium levels and the occurrence of ventricular arrhythmias. The results of the current analysis suggest that there is a need for change in our current concepts of the ideal serum potassium levels in patients with AMI.
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Joon Seok
authors.initials: JS
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Young A
authors.initials: YA
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Ha Yeon
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Chan Young
authors.initials: CY
authors.lastname: Oak
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Yong Un
authors.initials: YU
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Chang Seong
authors.initials: CS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Eun Hui
authors.initials: EH
authors.lastname: Bae
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Seong Kwon
authors.initials: SK
authors.lastname: Ma
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Young Keun
authors.initials: YK
authors.lastname: Ahn
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. Electronic address: kdksw@hanmail.net.
authors.forename: Soo Wan
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis; D011188:Potassium / Q000097:blood*; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
chemical_list: D011188:Potassium