Meta Analysis Of Serum Potassium Level And Prognosis In Patients With Acute Myocardial Infarction

Objectives: To investigate the relationship between admission serum potassium levels and prognosis in in patients with acute myocardial infarction(AMI).Methods: The relevant studies of literature about serum potassium level and prognosis in patients with AMI were collected by retrieving Pubmed, Cochrane Library,CNKI full-text database,VIP database.Then,the quality of included studies was evaluated, and the corresponding dada were extracted to conduct the meta-analysis. Review Mananger 4.2.2 software was used for meta-analysis,heterogeneity test set as P>0.10.Results:1?Hypokalemia vs normal blood potassium Because there is little heterogeneity in the included 6 studies(P=0.27<0.10,I2=21.8%),the fixed-effect model was adopted for meta-analysis.The result showed that there was statistical significance in the mortality between the normal and low serum potassium levels, and mortality rates were higher for hypokalemia [Z=4.81,P<0.05, OR: 1.54, 95%CI =(1.29, 1.84)].2?Hyperkalemia vs normal blood potassium Because there is much heterogeneity in the included 7 studies(P<0.10,I2=91.1%),the random-effect model was adopted for meta-analysis.The result showed that there was statistical significance in the mortality between the normal and high serum potassium levels,and mortality rates were higher for hyperkalemia[Z=3.71,P<0.05,OR:3.93,95%CI=(1.90,8.09)].3?Serum potassium level of 3.5-4.0mmol/L vs 4.0-4.5 mmol/L Short-term outcome Because there is little heterogeneity in the included 7 studies(P=0.19>0.10,I2=31.1%),the fixed-effect model was adopted for meta-analysis.The result showed that there was not statistical significance in the two groups. [Z=0.27, P=0.79>0.05,OR=0.98, 95%CI=(0.89,1.08)].Long-term outcome Because there is little heterogeneity in the included 4 studies(P=0.35>0.10,I2=8.1%),the fixed-effect model was adopted for meta-analysis. The result showed that there was not statistical significance in the two groups [Z=1.02, P=0.31>0.05,OR=0.91, 95%CI=(0.76,1.09)].4?Serum potassium level 3.5-4.0 mmol/L vs 4.5-5.0 mmol/L Short-term outcome Because there is little heterogeneity in the included 6 studies(P=0.17>0.10,I2=35.4%),the fixed-effect model was adopted for meta-analysis.The result showed that there was statistical significance in the mortality between serum potassium levels of 3.5-4.0 mmol/L vs 4.5-5.0 mmol/L, and mortality rates were higher for serum potassium level of 4.5-5.0 mmol/L [Z=12.32,P<0.05, OR=0.49, 95%CI=(0.44,0.55)].Long-term outcome Because there is little heterogeneity in the included 4 studies(P=0.99>0.10,I2=0%),the fixed-effect model was adopted for meta-analysis.The result showed that there was statistical significance in the mortality between serum potassium levels of3.5-4.0 mmol/L vs 4.5-5.0 mmol/L, and mortality rates were higher for serum potassium level of 4.5-5.0 mmol/L [Z=6.30,P<0.05,OR=0.47,95%CI(0.37,0.59)].5?Serum potassium levels of 3.5-4.5 mmol/L vs 4.0-5.0 mmol/L Short-term outcome Because there is little heterogeneity in the included 6 studies(P=0.95>0.10,I2=0%),the fixed-effect model was adopted for meta-analysis.The result showed that there was statistical significance in the mortality between serum potassium levels of 3.5-4.5 mmol/L vs 4.0-5.0 mmol/L, and mortality rates were higher for serum potassium level of 4.0-5.0 mmol/L [Z=5.68,P<0.05,OR=0.82, 95%CI=(0.76,0.88)].Long-term outcome Because there is little heterogeneity in the included 4 studies(P=0.76>0.10,I2=0%),the fixed-effect model was adopted for meta-analysis.The result showed that there was statistical significance in the mortality between serum potassium levels of 3.5-4.5 mmol/L vs 4.0-5.0 mmol/L, and mortality rates were higher for serum potassium level of 4.0-5.0 mmol/L [Z=3.06,P<0.05, OR=0.81,95%CI=(0.71,0.93)].Conelusion: This meta-analysis revealed a U-shaped relationship betwee admission serum potassium levels and long-term or short-term all-cause mortality in n AMI patients. Risks of death was significantly lower among patients with serum potassium levels of 3.5-4.5 mmol/L than among patients with serum potassium levels below 3.5 mmol/L or above 4.5 mmol/L.