Serum Potassium Levels and Mortality in Acute Myocardial Infarction

CONTEXT Clinical practice guidelines recommend maintaining serum potassium levels between 4.0 and 5.0 mEq/L in patients with acute myocardial infarction (AMI). These guidelines are based on small studies that associated low potassium levels with ventricular arrhythmias in the pre−β-blocker and prere...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2012-01, Vol.307 (2), p.157-164
Main Authors: Goyal, Abhinav, Spertus, John A, Gosch, Kensey, Venkitachalam, Lakshmi, Jones, Philip G, Van den Berghe, Greet, Kosiborod, Mikhail
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
Cardiology. Vascular system
Cohort Studies
Coronary heart disease
Databases, Factual
Epidemiology
Female
General aspects
Heart
Heart Arrest - epidemiology
Heart attacks
Hospital Mortality
Humans
Male
Medical sciences
Middle Aged
Mortality
Myocardial Infarction - blood
Myocardial Infarction - mortality
Odds Ratio
Patients
Potassium
Potassium - blood
Public health. Hygiene
Public health. Hygiene-occupational medicine
Retrospective Studies
Treatment Outcome
United States - epidemiology
Ventricular Fibrillation - epidemiology
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Summary:CONTEXT Clinical practice guidelines recommend maintaining serum potassium levels between 4.0 and 5.0 mEq/L in patients with acute myocardial infarction (AMI). These guidelines are based on small studies that associated low potassium levels with ventricular arrhythmias in the pre−β-blocker and prereperfusion era. Current studies examining the relationship between potassium levels and mortality in AMI patients are lacking. OBJECTIVE To determine the relationship between serum potassium levels and in-hospital mortality in AMI patients in the era of β-blocker and reperfusion therapy. DESIGN, SETTING, AND PATIENTS Retrospective cohort study using the Cerner Health Facts database, which included 38 689 patients with biomarker-confirmed AMI, admitted to 67 US hospitals between January 1, 2000, and December 31, 2008. All patients had in-hospital serum potassium measurements and were categorized by mean postadmission serum potassium level (
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.2011.1967