Language
English
Publication Date
5-1-2024
Journal
Cureus
DOI
10.7759/cureus.61126
PMID
38919213
PMCID
PMC11197046
PubMedCentral® Posted Date
5-26-2024
PubMedCentral® Full Text Version
Post-print
Abstract
Introduction: Disturbances in potassium levels can induce ventricular arrhythmias and heighten mortality in patients with ST-elevation myocardial infarction (STEMI). This study evaluates the influence of sK levels on seven-day mortality and incidence of ventricular arrhythmias in STEMI patients to further improve clinical guidelines and outcomes.
Methods: This retrospective, propensity-matched study analyzed approximately 250,000 acute STEMI patients from 55 major academic medical centers/healthcare organizations (HCOs) in the US Collaborative Network of the TriNetX database. The sK levels recorded on the day of STEMI diagnosis were categorized into four cohorts: sK ≤ 3.4 (hypokalemia), 3.5 ≤ sK ≤ 4.5 (normal-control), 4.6 ≤ sK ≤ 5.0 (high-normal), and sK ≥ 5.1 (hyperkalemia). Patient cohorts were propensity-matched using linear and logistic regression for demographics. Outcomes of seven-day mortality, ventricular tachycardia (VT), and ventricular fibrillation (VF) were compared between these cohorts and the control group.
Results: The analysis showed hypokalemia was linked to significantly higher seven-day mortality (7.2% vs. 4.3%; RR 1.69; p< 0.001), and increased rates of VT and VF. Similarly, hyperkalemia was associated with elevated mortality (12.7% vs. 4.6%; RR 2.76; p< 0.001), VT, and VF rates. High-normal sK levels showed increased mortality (7.4% vs. 4.7%; RR 1.58; p< 0.001), but unchanged VT or VF rates compared to the normal sK group.
Conclusion: This comprehensive study highlights the correlation of sK levels with death in STEMI patients, revealing a nearly doubled risk of mortality with hypokalemia and almost triples with hyperkalemia. More notably, the mortality for STEMIs is higher for high-normal vs normal sK values. Additionally, hypokalemia and hyperkalemia were found to significantly elevate VT and VF risks.
Keywords
ventricular dysrhythmia, st-elevation myocardial infarction, emergency medicine, cardiology, potassium
Published Open-Access
yes
Recommended Citation
Jensen, Colton J; Nielsen, Jonathan K; Talbott, Matthew M; et al., "Effects of Serum Potassium on Mortality in Patients With ST-Elevation Myocardial Infarction" (2024). Faculty and Staff Publications. 3923.
https://digitalcommons.library.tmc.edu/baylor_docs/3923