U-Shaped Association Between Potassium Level and Acute-MI Mortality

Hypokalemia was associated with increased mortality, but so were serum potassium levels ≥4.5 mEq/L, suggesting that repletion measures should be moderated.

On the basis of small studies with surrogate outcomes, current practice guidelines for managing ST-elevation myocardial infarction (STEMI) recommend maintaining a potassium level greater than 4.0 mEq/L. To explore the association of potassium levels with mortality, investigators used the Cerner Health Facts database to conduct a retrospective cohort study involving 38,689 patients with biomarker-confirmed acute MI and one or more serum potassium level measurements during hospitalization (mean number of measurements, 5.9). Mean admission potassium level was 4.2 mEq/L, and levels remained fairly constant during hospitalization.

In-hospital mortality was 6.9%. Mortality was lowest (4.8%) in patients with postadmission potassium levels of 3.5 to…

Reviewing Author

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute