Yu Quan, Liu Yang, Chang Xinyue, Mao Xueyu, Wu Xuechun, Chu Min, Niu Huicong, Shi Mengyao, Sun Lulu, He Yu, Liu Yi, Guo Daoxia, Zhu Zhengbao, Zhao Jing
Department of Psychiatry Affiliated Guangji Hospital of Soochow University, School of Public Health, Suzhou Medical College of Soochow University Suzhou China.
Department of Neurology, Minhang Hospital Fudan University Shanghai China.
J Am Heart Assoc. 2025 May 20;14(10):e037601. doi: 10.1161/JAHA.124.037601. Epub 2025 May 13.
High serum potassium, calcium, and magnesium levels have been reported to be associated with decreased risks of ischemic stroke, whereas their prognostic values in ischemic stroke remain unclear. We aimed to prospectively explore the associations of serum potassium, calcium, and magnesium levels with the prognosis of ischemic stroke.
We measured serum potassium, calcium, and magnesium levels at baseline among 5469 patients with ischemic stroke from the Minhang Stroke Cohort study. The primary outcome was the composite outcome of death and major disability (modified Rankin Scale score ≥3) at 3 months after ischemic stroke. Secondary outcomes included major disability, death, and the ordered 7-level categorical score of the modified Rankin Scale.
During 3-month follow-up, 1834 patients developed the primary outcome. After multivariate adjustment, the adjusted odds ratios of primary outcome for the highest versus the lowest quartile were 0.79 (95% CI, 0.68-0.93; =0.007) for potassium, 0.69 (95% CI, 0.58-0.82; <0.001) for calcium, and 0.83 (95% CI, 0.70-0.99; =0.015) for magnesium. Multivariable-adjusted restricted cubic spline analyses showed linear dose-response relationships of serum potassium, calcium, and magnesium with the risk of primary outcome (all for linearity<0.05).
High-normal serum potassium, calcium, and magnesium levels were associated with decreased risks of adverse outcomes at 3 months after ischemic stroke, suggesting that serum potassium, calcium, and magnesium might be valuable prognostic biomarkers for ischemic stroke.
据报道，血清钾、钙和镁水平升高与缺血性中风风险降低有关，但其在缺血性中风中的预后价值仍不清楚。我们旨在前瞻性地探讨血清钾、钙和镁水平与缺血性中风预后的关系。
我们在闵行中风队列研究中测量了5469例缺血性中风患者基线时的血清钾、钙和镁水平。主要结局是缺血性中风后3个月时死亡和严重残疾（改良Rankin量表评分≥3）的复合结局。次要结局包括严重残疾、死亡以及改良Rankin量表的有序7级分类评分。
在3个月的随访期间，1834例患者出现了主要结局。多变量调整后，钾最高四分位数与最低四分位数相比，主要结局的调整比值比为0.79（95%CI，0.68 - 0.93；P = 0.007），钙为0.69（95%CI，0.58 - 0.82；P < 0.001），镁为0.83（95%CI，0.70 - 0.99；P = 0.015）。多变量调整后的受限立方样条分析显示血清钾、钙和镁与主要结局风险呈线性剂量反应关系（所有线性P值<0.05）。
血清钾、钙和镁处于略高水平与缺血性中风后3个月不良结局风险降低相关，提示血清钾、钙和镁可能是缺血性中风有价值的预后生物标志物。
