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Relation between admission serum potassium levels and long-term mortality in acute coronary syndrome

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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.

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Acknowledgments

The work was supported by a grant from the National High-Tech Research and Development Program of China (2012AA02A510, Beijing, China) and the Chinese National Nature Science Foundation (grant numbers 81400267 and 81370219, Beijing, China).

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with human and animal performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Correspondence to Hua Wang or Mao Chen.

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Y. Peng and F.-Y Huang contributed equally to this work.

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Peng, Y., Huang, Fy., Liu, W. et al. Relation between admission serum potassium levels and long-term mortality in acute coronary syndrome. Intern Emerg Med 10, 927–935 (2015). https://doi.org/10.1007/s11739-015-1253-1

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  • DOI: https://doi.org/10.1007/s11739-015-1253-1

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