title: Relation between admission serum potassium levels and long-term mortality in acute coronary syndrome.
abstract: Serum potassium homeostasis play an important role in myocardial function, but the impact of serum potassium levels on long-term mortality has not been well evaluated. In the current study, we investigated patients with acute coronary syndrome (ACS) and analyzed the relationship between admission serum potassium levels and long-term mortality. Between July 2008 and September 2012, 2369 patients with ACS that was confirmed by coronary angiography were enrolled in this study and completed the follow-up. The serum potassium level was evaluated within first 24 h after admission. The primary outcome in this study was all-cause mortality. Patients were categorized into five groups to determine the relation between admission serum potassium levels 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. There was a U-shaped relationship between admission serum potassium levels and long-term mortality that persisted after multivariable adjustment. The mortality risk was lowest in the group of patients with potassium levels of 3.5 to < 4.0 mEq/L, whereas mortality was higher in patients with potassium levels > 4.5 [hazard ratio (HR) 1.62, 95 % confidence interval (CI) 0.90 to 2.93 and HR 1.55, 95 % CI 0.54 to 4.49, for patients with potassium levels of 4.5 to < 5.0 mEq/L and ≥ 5.0 mEq/L, respectively] or < 3.5 mEq/L (HR 2.14, 95 % CI 1.28 to 3.59). There was a U-shaped relationship between admission serum potassium levels and long-term mortality for ACS patients; in particular, among the examined patients, the lowest mortality was observed in those with admission serum potassium levels of between 3.5 and < 4.5 mEq/L compared with those who had higher or lower potassium levels.
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People's Republic of China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People's Republic of China.
authors.forename: Fang-yang
authors.initials: FY
authors.lastname: Huang
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People's Republic of China.
authors.forename: Chen
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People's Republic of China.
authors.forename: Zhen-gang
authors.initials: ZG
authors.lastname: Zhao
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People's Republic of China.
authors.forename: Bao-tao
authors.initials: BT
authors.lastname: Huang
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People's Republic of China.
authors.forename: Yan-biao
authors.initials: YB
authors.lastname: Liao
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People's Republic of China.
authors.forename: Qiao
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People's Republic of China.
authors.forename: Hua
authors.initials: H
authors.lastname: Chai
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People's Republic of China.
authors.forename: Xiao-lin
authors.initials: XL
authors.lastname: Luo
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Ren
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People's Republic of China.
authors.forename: Chi
authors.initials: C
authors.lastname: Chen
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People's Republic of China.
authors.forename: Qing-tao
authors.initials: QT
authors.lastname: Meng
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People's Republic of China.
authors.forename: De-jia
authors.initials: DJ
authors.lastname: Huang
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People's Republic of China. wanghua7902@163.com.
authors.forename: Hua
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People's Republic of China. hmaochen@vip.sina.com.
authors.forename: Mao
authors.initials: M
authors.lastname: Chen
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000401:mortality*; D000368:Aged; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011188:Potassium / Q000097:blood*; D011446:Prospective Studies; D012737:Sex Factors
chemical_list: D011188:Potassium
keywords: Acute coronary syndrome; Long-term prognosis; Serum potassium levels