Keskin Muhammed, Kaya Adnan, Tatlısu Mustafa Adem, Hayıroğlu Mert İlker, Uzman Osman, Börklü Edibe Betül, Çinier Göksel, Çakıllı Yasin, Yaylak Barış, Eren Mehmet
Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Department of Cardiology, Istanbul,Turkey.
Suruc State Hospital, Sanliurfa, Turkey.
Int J Cardiol. 2016 Oct 15;221:505-10. doi: 10.1016/j.ijcard.2016.07.024. Epub 2016 Jul 5.
Current studies evaluating the effect of serum potassium levels on mortality in patients with ST elevation myocardial infarction (STEMI) are lacking. We analyzed retrospectively 3760 patients diagnosed with STEMI. Mean serum potassium levels were categorized accordingly: <3.0, 3.0 to <3.5, 3.5 to <4.0, 4.0 to <4.5, 4.5 to <5.0, 5.0 to <5.5, and ≥5.5mEq/L. The lowest mortality was determined in patients with serum potassium level of 4 to <4.5mEq/L whereas mortality was higher in patients with serum potassium levels of ≥5.0 and <3.5mEq/L. In a multivariable Cox-proportional regression analysis, the mortality risk was higher for patients with serum potassium levels of ≥5mEq/L [hazard ratio (HR), 2.11; 95% confidence interval (CI) 1.23-4.74 and HR, 4.20; 95% CI 1.08-8.23, for patients with potassium levels of 5 to <5.5mEq/L and ≥5.5mEq/L, respectively]. In-hospital and long-term mortality risks were also higher for patients with serum potassium levels of ≤3.5mEq/L. Conversely, ventricular arrhythmias were higher only for patients with serum potassium level of ≤3.5mEq/L. Furthermore, a significant relationship was found between the patient with serum potassium levels of ≤3.5mEq/L and ventricular arrhythmias.
目前尚无评估血清钾水平对ST段抬高型心肌梗死(STEMI)患者死亡率影响的研究。我们回顾性分析了3760例诊断为STEMI的患者。根据血清钾平均水平进行分类:<3.0、3.0至<3.5、3.5至<4.0、4.0至<4.5、4.5至<5.0、5.0至<5.5以及≥5.5mEq/L。血清钾水平为4至<4.5mEq/L的患者死亡率最低,而血清钾水平≥5.0和<3.5mEq/L的患者死亡率较高。在多变量Cox比例回归分析中,血清钾水平≥5mEq/L的患者死亡风险更高[风险比(HR),2.11;95%置信区间(CI)1.23 - 4.74,对于钾水平为5至<5.5mEq/L的患者;HR,4.20;95%CI 1.08 - 8.23,对于钾水平≥5.5mEq/L的患者]。血清钾水平≤3.5mEq/L的患者住院和长期死亡风险也更高。相反,仅血清钾水平≤3.5mEq/L的患者室性心律失常发生率更高。此外,血清钾水平≤3.5mEq/L的患者与室性心律失常之间存在显著关系。