Prognostic impact of potassium levels in patients with ventricular tachyarrhythmias
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ORIGINAL PAPER
Prognostic impact of potassium levels in patients with ventricular tachyarrhythmias Tobias Schupp1 · Thomas Bertsch2 · Max von Zworowsky1 · Seung‑Hyun Kim1 · Kathrin Weidner1 · Jonas Rusnak1 · Christian Barth1 · Linda Reiser1 · Gabriel Taton1 · Thomas Reichelt1 · Dominik Ellguth1 · Niko Engelke1 · Armin Bollow1 · Muharrem Akin3 · Kambis Mashayekhi4 · Dirk Große Meininghaus5 · Martin Borggrefe1 · Ibrahim Akin1 · Michael Behnes1 Received: 4 November 2019 / Accepted: 24 February 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background The study sought to assess the prognostic impact of potassium levels (K) in patients with ventricular tachyarrhythmias. Methods A large retrospective registry was used including all consecutive patients presenting with ventricular tachyarrhythmias on admission from 2002 to 2016. Patients with hypokalemia (i.e., K 4.5 mmol/L) were compared applying multi-variable Cox regression models and propensity-score matching for evaluation of the primary endpoint of all-cause mortality at 3 years. Secondary endpoints were early cardiac death at 24 h, in-hospital death, death at 30 days, as well as the composite endpoint of early cardiac death at 24 h, recurrences of ventricular tachyarrhythmias, and appropriate ICD therapies at 3 years. Results In 1990 consecutive patients with ventricular tachyarrhythmias, 63% of the patients presented with normokalemia, 30% with hyperkalemia, and 7% with hypokalemia. After propensity matching, both hypokalemic (HR = 1.545; 95% CI 0.970–2.459; p = 0.067) and hyperkalemic patients (HR = 1.371; 95% CI 1.094–1.718; p = 0.006) were associated with the primary endpoint of all-cause mortality at 3 years compared to normokalemic patients. Hyperkalemia was associated with even worse prognosis directly compared to hypokalemia (HR = 1.496; 95% CI 1.002–2.233; p = 0.049). In contrast, potassium measurements were not associated with the composite endpoint at 3 years.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00392-020-01624-x) contains supplementary material, which is available to authorized users. * Ibrahim Akin [email protected] 1
Department of Medicine, Faculty of Medicine Mannheim, European Center for AngioScience (ECAS), and DZHK (German Center for Cardiovascular Research) partner site, University Medical Centre Mannheim (UMM), University of Heidelberg, Heidelberg/Mannheim, Mannheim, Germany
2
Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, General Hospital Nuremberg, Paracelsus Medical University, Nuremberg, Germany
3
Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
4
Department of Cardiology and Angiology II, University Heart Center Freiburg, Bad Krozingen, Germany
5
Department of Cardiology, Carl‑Thiem‑Klinikum Cottbus, Cottbus, Germany
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Vol.:(0123456789)
Clinical Research in Cardiology
Conclusion In patients presenting with ventricular tachyarrhythmias, normokalemia wa
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