Potassium variability during hospitalization and outcomes after discharge in patients with acute myocardial infarction

作     者：Xi-Ling ZHANG Heng-Xuan CAI Shan-Jie WANG Xiao-Yuan ZHANG Xin-Ran HAO Shao-Hong FANG Xue-Qin GAO Bo YU Xi-Ling ZHANG;Heng-Xuan CAI;Shan-Jie WANG;Xiao-Yuan ZHANG;Xin-Ran HAO;Shao-Hong FANG;Xue-Qin GAO;Bo YU

作者机构：Department of CardiologySecond Affiliated Hospital of Harbin Medical UniversityHarbinChina The Key Laboratory of Myocardial IschemiaChinese Ministry of Education246 Xuefu RoadNangang DistrictHarbinChina Department of NeurobiologyNeurobiology Key LaboratoryHarbin Medical UniversityEducation Department of Heilongjiang ProvinceHarbinChina 

出 版 物：《Journal of Geriatric Cardiology》 (老年心脏病学杂志（英文版）)

年 卷 期：2021年第18卷第1期

页      面：10-19页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：supported by the National Key R&D Program of China(No.2016YFC1301100) National Natural Science Foundation of China(No.81827806,81870353,31771241) Key Laboratory of Myocardial Ischemia,Ministry of Education(No.KF201903) 

主　　题：AMI BNP Potassium variability during hospitalization and outcomes after discharge in patients with acute myocardial infarction 

摘      要：BACKGROUND The variability of metabolic biomarkers has been determined to provide incremental prognosis information,but the implications of electrolyte variability remained *** We investigate the relationships between electrolyte fluctuation and outcomes in survivors of acute myocardial infarction(n=4386).Ion variability was calculated as the coefficient of variation,standard deviation,variability independent of the mean(VIM)and *** ratios(HR)were estimated using the multivariable-adjusted Cox proportional regression *** During a median follow-up of 12 months,161(3.7%)patients died,and heart failure occurred in 550(12.5%)participants after discharge,*** 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(c Tn I),N terminal pro B type natriuretic peptide(NT-pro BNP),infarction site,mean potassium and other traditional factors,while those associations across sodium VIM quartiles were *** trend remains across the strata of variability by other three *** associations were consistent after excluding patients with any extreme electrolyte value and diuretic *** Higher potassium variability but not sodium variability was associated with adverse outcomes *** findings highlight that potassium variability remains a robust risk factor for mortality regardless of clinical dysnatraemia and dyskalaemia.