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Vol 26, No 2 (2020)
Research paper
Published online: 2020-07-29

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Prognostic significance of serum potassium level for major adverse cardiac events and death in patients with coronary atherosclerotic disease

Afrasyab Altaf1, Aftab Alam1, Momin Salahuddin2, Momin Khan1, Mazhar Mahmood1, Hammad Shah2, Karamat Ali Shah2
Acta Angiologica 2020;26(2):58-64.


Introduction: Serum potassium levels have been shown in some animal studies to be associated with the
process of atherosclerosis. We decided to assess the correlation of serum potassium level in ischemic heart disease
patients with disease severity and its relationship with prognosis in terms of major acute cardiac events (MACE).

Material and methods: This was a cross-sectional cohort study carried out at cardiology department of Rehman
Medical Institute, from July 2016 to 31st Aug. 2018 a period of 26 months. 622 patients were included in the
study. Clinical and angiographic characteristics were assessed based on the serum potassium level. Correlation of
serum potassium level with Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery
(SYNTAX) and Gensini scores was also evaluated. Follow up for MACE was carried out after one year.

Results: Mean serum potassium level was 3.93 ± 0.95 (mEq/l) in coronary artery disease patients. Serum
potassium level showed negative correlation with SYNTAX score (r = –0.60, p < 0.05) and Gensini score
(r = –0.64, p < 0.05). There was also a significant difference between low and high potassium level in relation
to the multi-vessel disease on coronary angiography (p < 0.05). Low potassium level was a good predictor of
adverse outcomes as shown by Kaplan-Meier analysis. Multivariate Cox regression analysis showed that serum
potassium level and diabetes were independent predictors of MACE (p < 0.05).

Conclusion: Low serum potassium level is correlated with more severe coronary atherosclerosis. Low potassium
levels are associated with significantly poor outcomes.

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