Abstract: PO1451
Can Potassium Be a Predictor of Cardiovascular Mortality?
Session Information
- Fluid, Electrolyte, and Acid-Base Disorders: Clinical - 1
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Fluid, Electrolyte, and Acid-Base Disorders
- 902 Fluid, Electrolyte, and Acid-Base Disorders: Clinical
Authors
- Mateus, Catarina, Centro Hospitalar Lisboa Ocidental - Hospital de Santa Cruz, Lisbon, Portugal
- Ormonde, Carolina, Hospital do Divino Espirito Santo de Ponta Delgada EPE, Ponta Delgada, Ilha de São Miguel, Portugal
- Brízido, Catarina, Centro Hospitalar Lisboa Ocidental - Hospital de Santa Cruz, Lisbon, Portugal
- Martins, Ana Rita Mateus, Centro Hospitalar Lisboa Ocidental - Hospital de Santa Cruz, Lisbon, Portugal
- Branco, Patricia Quadros, Centro Hospitalar Lisboa Ocidental - Hospital de Santa Cruz, Lisbon, Portugal
Background
Epidemiologic data demonstrates association between hyperkalaemia and mortality. Patients with ST-segment elevation myocardial infarction (STEMI) often have comorbidities that are associated with hyperkalaemia, such as Chronic Kidney Disease (CKD) and Diabetes Mellitus (DM). The aim of our study was to analyse hyperkalaemia as a prognostic factor in patients with STEMI.
Methods
Retrospective single-center analysis of all patients admitted for STEMI and undergoing primary percutaneous coronary intervention in a two-year period (January 2009 to December 2010). Demographic aspects, comorbidities, potassium level at admission and outcomes were evaluated. Hyperkalaemia was defined as potassium level superior to 5 mmol/l.
Results
Overall, 276 patients were included (mean age 62 ± 14 years, 75% males), 55% had hypertension, 20% diabetes mellitus and 14% previous myocardial infarction. Only 14% were pretreated with renin–angiotensin–aldosterone system inhibitors (RAASi).
The median potassium at admission was 4 mmol/l (IQR 3.7 - 4.4mmol/l), and the median creatinine level at admission was 0.88 mg/dl (IQR 0.74 - 1.1mg/dl). 5-year all-cause mortality was 23%. Univariable analysis revealed that age (p <0.001), previous myocardial infarction (p 0.038) and hyperkalaemia at admission (p 0.039) were associated with 5-year all-cause mortality. After adjustment for therapy with RAASi, higher potassium level at admission was associated with 5-year all-cause mortality (adjusted HR 1.55, 95%CI 1,01-2,38; p 0. 045).
Conclusion
In our study, potassium at admission was a predictor of 5-year all-cause mortality. Potassium measurement is an easy tool to help in risk stratification in this population. Further studies are needed to access if pharmacological control of potassium levels will change prognosis.