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

Introduction: Serum potassium levels have been shown in some animal studies to be associated with theprocess of atherosclerosis. We decided to assess the correlation of serum potassium level in ischemic heart diseasepatients 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 RehmanMedical Institute, from July 2016 to 31st Aug. 2018 a period of 26 months. 622 patients were included in thestudy. Clinical and angiographic characteristics were assessed based on the serum potassium level. Correlation ofserum 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. Serumpotassium 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 relationto the multi-vessel disease on coronary angiography (p < 0.05). Low potassium level was a good predictor ofadverse outcomes as shown by Kaplan-Meier analysis. Multivariate Cox regression analysis showed that serumpotassium level and diabetes were independent predictors of MACE (p < 0.05). Conclusion: Low serum potassium level is correlated with more severe coronary atherosclerosis. Low potassiumlevels are associated with significantly poor outcomes