Serum potassium and in-hospital mortality in acute myocardial infarction

Bottom line:  Guidelines have recommended maintaining potassium between 4.0 and 5.0 mEq/L or 4.5 to 5.5 mEq/L; however, a recent study of patients admitted for AMI reported lowest rates of mortality in patients with mean potassium between between 3.5 and 4.5 mEq/L.

SummaryGoyal A, et al.  Serum Potassium Levels and Mortality  in Acute Myocardial Infarction. JAMA. 2012; 307(2): 157-164.
Retrospective cohort study of 38,689 patients with biomarker-confirmed AMI, admitted to 67 US hospitals.  All patients had in-hospital serum potassium measurements.  RESULTS:  Adjusted odds ratios for all-cause mortality by mean potassium:
3.5 - <4.0 mEq/L, OR was 1.0
4.0 – <4.5 mEq/L, OR was 1.25
4.5 – <5.0 mEq/L, OR was 1.96
5.0 – <5.5 mEq/L, OR was 3.27
See Table 2 (p.161) for details.

Current recommendations:

ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines

New Guidelines for Potassium Replacement in Clinical Practice: A Contemporary Review by the National Council on Potassium in Clinical Practice

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About Amy

Clinical Informationist at EUH Branch Library
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