Potassium variability during hospitalization and outcomes after discharge in patients with acute myocardial infarction
Xi-Ling ZHANG1
Heng-Xuan CAI1
Shan-Jie WANG1
Xiao-Yuan ZHANG1
Xin-Ran HAO2
Shao-Hong FANG1
Xue-Qin GAO1
Bo YU1
1.Department of Cardiology,Second Affiliated Hospital of Harbin Medical University,Harbin,China;The Key Laboratory of Myocardial Ischemia,Chinese Ministry of Education,246 Xuefu Road,Nangang District,Harbin,China2.The Key Laboratory of Myocardial Ischemia,Chinese Ministry of Education,246 Xuefu Road,Nangang District,Harbin,China;Department of Neurobiology,Neurobiology Key Laboratory,Harbin Medical University,Education Department of Heilongjiang Province,Harbin,China
摘要：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 in-farction(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％)parti-cipants 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 electro-lyte value and diuretic use.CONCLUSIONS Higher potassium variability but not sodium variability was associated with adverse outcomes post-infarc-tion.Our findings highlight that potassium variability remains a robust risk factor for mortality regardless of clinical dys-natraemia and dyskalaemia.
机标关键词：
论文发表日期：2021-01-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：10( 10-19 )