Association of abnormal serum potassium levels with arrhythmias and cardiovascular mortality

• Verfasst von: Hoppe, Liesa Katharina [VerfasserIn]
• Verfasst von: Laetsch, Dana Clarissa [VerfasserIn]
• Verfasst von: Brenner, Hermann [VerfasserIn]
• Verfasst von: Schöttker, Ben [VerfasserIn]
• Titel: Association of abnormal serum potassium levels with arrhythmias and cardiovascular mortality
• Titelzusatz: a systematic review and meta-analysis of observational studies
• Verf.angabe: Liesa K. Hoppe, Dana C. Muhlack, Wolfgang Koenig, Prudence R. Carr, Hermann Brenner, Ben Schöttker
• Jahr: 2018
• Umfang: 16 S.
• Teil: volume:32
• Teil: year:2018
• Teil: number:2
• Teil: pages:197-212
• Teil: extent:16
• Fussnoten: First online: 20 April 2018 ; Gesehen am 27.06.2018
• Titel Quelle: Enthalten in: Cardiovascular drugs and therapy
• Ort Quelle: Dordrecht [u.a.] : Springer Science + Business Media B.V, 1987
• Jahr Quelle: 2018
• Band/Heft Quelle: 32(2018), 2, Seite 197-212
• ISSN Quelle: 1573-7241
• DOI: doi:10.1007/s10557-018-6783-0
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1576925013

Abstract

Purpose: To provide the first systematic review and meta-analysis of observational studies on the association of abnormal serum potassium and cardiovascular outcomes.Methods: Medline and ISI Web of Knowledge were systematically searched from inception until November 24, 2017. Data synthesis of relevant studies was performed using random effects model meta-analyses.Results: Meta-analyses included 310,825 participants from 24 studies. In the older general population, low serum potassium was associated with a 1.6-fold increased risk of supraventricular arrhythmias (risk ratio [95% confidence interval] 1.62 [1.02-2.55]). Contrarily, high serum potassium was associated with increased cardiovascular mortality (CVM) (1.38 [1.14-1.66]). In patients with acute myocardial infarction, the risk of ventricular arrhythmias was increased for high serum potassium (2.33 [1.60-3.38]). A U-shaped association was observed with a composite cardiovascular outcome in hypertensive patients (2.6-fold increased risk with hypokalemia and 1.7-fold increased risk with hyperkalemia), with CVM in dialysis patients (1.1-fold increased risk with hypokalemia and 1.4-fold increased risk with hyperkalemia) and with CVM in heart failure patients (albeit not statistically significant). Further, only hyperkalemia was associated with an increased risk of a composite cardiovascular outcome in both dialysis (1.12 [1.03-1.23]) and chronic kidney disease (1.34 [1.06-1.71]) patients.Conclusions: Controlled clinical trials are needed to determine which populations may profit from more frequent potassium-monitoring and subsequent interventions, e.g., change or withdrawal of potassium-influencing drugs, in order to restore normal values and prevent cardiovascular outcomes.