Potassium Disturbances and Risk of Ventricular Fibrillation Among Patients With ST‐Segment–Elevation Myocardial Infarction
Background Potassium disturbances per se increase the risk of ventricular fibrillation (VF). Whether potassium disturbances in the acute phase of ST‐segment–elevation myocardial infarction (STEMI) are associated with VF before primary percutaneous coronary intervention (PPCI) is uncertain. Methods a...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.014160 |
| _version_ | 1797884390156533760 |
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| author | Mia Ravn Jacobsen Reza Jabbari Charlotte Glinge Niels Kjær Stampe Jawad Haider Butt Paul Blanche Jacob Lønborg Olav Wendelboe Nielsen Lars Køber Christian Torp‐Pedersen Frants Pedersen Jacob Tfelt‐Hansen Thomas Engstrøm |
| author_facet | Mia Ravn Jacobsen Reza Jabbari Charlotte Glinge Niels Kjær Stampe Jawad Haider Butt Paul Blanche Jacob Lønborg Olav Wendelboe Nielsen Lars Køber Christian Torp‐Pedersen Frants Pedersen Jacob Tfelt‐Hansen Thomas Engstrøm |
| author_sort | Mia Ravn Jacobsen |
| collection | DOAJ |
| description | Background Potassium disturbances per se increase the risk of ventricular fibrillation (VF). Whether potassium disturbances in the acute phase of ST‐segment–elevation myocardial infarction (STEMI) are associated with VF before primary percutaneous coronary intervention (PPCI) is uncertain. Methods and Results All consecutive STEMI patients were identified in the Eastern Danish Heart Registry from 1999 to 2016. Comorbidities and medication use were assessed from Danish nationwide registries. Potassium levels were collected immediately before PPCI start. Multivariate logistic models were performed to determine the association between potassium and VF. The main analysis included 8624 STEMI patients of whom 822 (9.5%) had VF before PPCI. Compared with 6693 (77.6%) patients with normokalemia (3.5–5.0 mmol/L), 1797 (20.8%) patients with hypokalemia (<3.5 mmol/L) were often women with fewer comorbidities, whereas 134 (1.6%) patients with hyperkalemia (>5.0 mmol/L) were older with more comorbidities. After adjustment, patients with hypokalemia and hyperkalemia had a higher risk of VF before PPCI (odds ratio 1.90, 95% CI 1.57–2.30, P<0.001) and (odds ratio 3.36, 95% CI 1.95–5.77, P<0.001) compared with normokalemia, respectively. Since the association may reflect a post‐resuscitation phenomenon, a sensitivity analysis was performed including 7929 STEMI patients without VF before PPCI of whom 127 (1.6%) had VF during PPCI. Compared with normokalemia, patients with hypokalemia had a significant association with VF during PPCI (odds ratio 1.68, 95% CI 1.01–2.77, P=0.045) after adjustment. Conclusions Hypokalemia and hyperkalemia are associated with increased risk of VF before PPCI during STEMI. For hypokalemia, the association may be independent of the measurement of potassium before or after VF. |
| first_indexed | 2024-04-10T04:06:29Z |
| format | Article |
| id | doaj.art-216fcebe3ad94dc48a2e3207a37d0abe |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-10T04:06:29Z |
| publishDate | 2020-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-216fcebe3ad94dc48a2e3207a37d0abe2023-03-13T05:25:33ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-02-019410.1161/JAHA.119.014160Potassium Disturbances and Risk of Ventricular Fibrillation Among Patients With ST‐Segment–Elevation Myocardial InfarctionMia Ravn Jacobsen0Reza Jabbari1Charlotte Glinge2Niels Kjær Stampe3Jawad Haider Butt4Paul Blanche5Jacob Lønborg6Olav Wendelboe Nielsen7Lars Køber8Christian Torp‐Pedersen9Frants Pedersen10Jacob Tfelt‐Hansen11Thomas Engstrøm12Department of Cardiology, Rigshospitalet Copenhagen University Hospital Copenhagen DenmarkDepartment of Cardiology, Rigshospitalet Copenhagen University Hospital Copenhagen DenmarkDepartment of Cardiology, Rigshospitalet Copenhagen University Hospital Copenhagen DenmarkDepartment of Cardiology, Rigshospitalet Copenhagen University Hospital Copenhagen DenmarkDepartment of Cardiology, Rigshospitalet Copenhagen University Hospital Copenhagen DenmarkDepartment of Cardiology, Rigshospitalet Copenhagen University Hospital Copenhagen DenmarkDepartment of Cardiology, Rigshospitalet Copenhagen University Hospital Copenhagen DenmarkDepartment of Cardiology Bispebjerg and Frederiksberg University Hospital Copenhagen DenmarkDepartment of Cardiology, Rigshospitalet Copenhagen University Hospital Copenhagen DenmarkDepartment of Cardiology Aalborg University Hospital Aalborg DenmarkDepartment of Cardiology, Rigshospitalet Copenhagen University Hospital Copenhagen DenmarkDepartment of Cardiology, Rigshospitalet Copenhagen University Hospital Copenhagen DenmarkDepartment of Cardiology, Rigshospitalet Copenhagen University Hospital Copenhagen DenmarkBackground Potassium disturbances per se increase the risk of ventricular fibrillation (VF). Whether potassium disturbances in the acute phase of ST‐segment–elevation myocardial infarction (STEMI) are associated with VF before primary percutaneous coronary intervention (PPCI) is uncertain. Methods and Results All consecutive STEMI patients were identified in the Eastern Danish Heart Registry from 1999 to 2016. Comorbidities and medication use were assessed from Danish nationwide registries. Potassium levels were collected immediately before PPCI start. Multivariate logistic models were performed to determine the association between potassium and VF. The main analysis included 8624 STEMI patients of whom 822 (9.5%) had VF before PPCI. Compared with 6693 (77.6%) patients with normokalemia (3.5–5.0 mmol/L), 1797 (20.8%) patients with hypokalemia (<3.5 mmol/L) were often women with fewer comorbidities, whereas 134 (1.6%) patients with hyperkalemia (>5.0 mmol/L) were older with more comorbidities. After adjustment, patients with hypokalemia and hyperkalemia had a higher risk of VF before PPCI (odds ratio 1.90, 95% CI 1.57–2.30, P<0.001) and (odds ratio 3.36, 95% CI 1.95–5.77, P<0.001) compared with normokalemia, respectively. Since the association may reflect a post‐resuscitation phenomenon, a sensitivity analysis was performed including 7929 STEMI patients without VF before PPCI of whom 127 (1.6%) had VF during PPCI. Compared with normokalemia, patients with hypokalemia had a significant association with VF during PPCI (odds ratio 1.68, 95% CI 1.01–2.77, P=0.045) after adjustment. Conclusions Hypokalemia and hyperkalemia are associated with increased risk of VF before PPCI during STEMI. For hypokalemia, the association may be independent of the measurement of potassium before or after VF.https://www.ahajournals.org/doi/10.1161/JAHA.119.014160potassium disturbancesST‐segment–elevation myocardial infarctionventricular fibrillation |
| spellingShingle | Mia Ravn Jacobsen Reza Jabbari Charlotte Glinge Niels Kjær Stampe Jawad Haider Butt Paul Blanche Jacob Lønborg Olav Wendelboe Nielsen Lars Køber Christian Torp‐Pedersen Frants Pedersen Jacob Tfelt‐Hansen Thomas Engstrøm Potassium Disturbances and Risk of Ventricular Fibrillation Among Patients With ST‐Segment–Elevation Myocardial Infarction Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease potassium disturbances ST‐segment–elevation myocardial infarction ventricular fibrillation |
| title | Potassium Disturbances and Risk of Ventricular Fibrillation Among Patients With ST‐Segment–Elevation Myocardial Infarction |
| title_full | Potassium Disturbances and Risk of Ventricular Fibrillation Among Patients With ST‐Segment–Elevation Myocardial Infarction |
| title_fullStr | Potassium Disturbances and Risk of Ventricular Fibrillation Among Patients With ST‐Segment–Elevation Myocardial Infarction |
| title_full_unstemmed | Potassium Disturbances and Risk of Ventricular Fibrillation Among Patients With ST‐Segment–Elevation Myocardial Infarction |
| title_short | Potassium Disturbances and Risk of Ventricular Fibrillation Among Patients With ST‐Segment–Elevation Myocardial Infarction |
| title_sort | potassium disturbances and risk of ventricular fibrillation among patients with st segment elevation myocardial infarction |
| topic | potassium disturbances ST‐segment–elevation myocardial infarction ventricular fibrillation |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.014160 |
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