On the basis of high-quality observational data, Goyal et al. have found that serum potassium levels <3.5 mmol/l or ≥4.5 mmol/l are associated with increased in-hospital mortality in patients with acute myocardial infarction. We discuss whether target potassium levels in clinical practice and guidelines should be changed to 3.5–4.5 mmol/l.
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References
Goyal, A. et al. Serum potassium levels and mortality in acute myocardial infarction. JAMA 307, 157–164 (2012).
Cohn, J. N., Kowey, P. R., Whelton, P. K. & Prisant, L. M. New guidelines for potassium replacement in clinical practice: a contemporary review by the National Council on Potassium in Clinical Practice. Arch. Intern. Med. 160, 2429–2436 (2000).
Brown, M. J., Brown, D. C. & Murphy, M. B. Hypokalemia from beta2-receptor stimulation by circulating epinephrine. N. Engl. J. Med. 309, 1414–1419 (1983).
Solomon, R. J. & Cole, A. G. Importance of potassium in patients with acute myocardial infarction. Acta Med. Scand. 209, 87–93 (1981).
Friedensohn, A., Faibel, H. E., Bairey, O., Goldbourt, U. & Schlesinger, Z. Malignant arrhythmias in relation to values of serum potassium in patients with acute myocardial infarction. Int. J. Cardiol. 32, 331–338 (1991).
Kafka, H., Langevin, L. & Armstrong, P. W. Serum magnesium and potassium in acute myocardial infarction. Influence on ventricular arrhythmias. Arch. Intern. Med. 147, 465–469 (1987).
Macdonald, J. E. & Struthers, A. D. What is the optimal serum potassium level in cardiovascular patients? J. Am. Coll. Cardiol. 43, 155–161 (2004).
Birman-Deych, E. et al. Accuracy of ICD-9-CM codes for identifying cardiovascular and stroke risk factors. Med. Care 43, 480–485 (2005).
Antman, E. M. for the Magnesium in Coronaries (MAGIC) Trial Investigators. Early administration of intravenous magnesium to high-risk patients with acute myocardial infarction in the Magnesium in Coronaries (MAGIC) trial: a randomised controlled trial. Lancet 360, 1189–1196 (2002).
Antman, E. M. et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction—executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). Circulation 110, 588–636 (2004).
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van Diepen, S., Granger, C. Challenging accepted post-MI serum potassium targets. Nat Rev Cardiol 9, 259–260 (2012). https://doi.org/10.1038/nrcardio.2012.28
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DOI: https://doi.org/10.1038/nrcardio.2012.28
