Transient decrease in serum potassium level during ischemic attack of acute coronary syndrome: paradoxical contribution of plasma glucose level and glycohemoglobin.
Transient decrease in serum potassium level during ischemic attack of acute coronary syndrome: paradoxical contribution of plasma glucose level and glycohemoglobin.
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DOI：
10.1186/1475-2840-12-4
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发表时间：
2013-01-04
影响因子：
9.3
通讯作者：
Yoshimura M
中科院分区：
文献类型：
--
作者：
Sekiyama H;Nagoshi T;Komukai K;Matsushima M;Katoh D;Ogawa K;Minai K;Ogawa T;Yoshimura M
尽管血清钾水平降低已被认为是急性冠状动脉综合征（ACS）中相当常见的观察结果，但迄今为止，还没有明确的报告直接证明ACS缺血发作期间与个体患者稳定期相比存在短暂的钾降低（钾骤降）。为了了解钾骤降的病理生理学意义，我们检测了缺血发作期间血清钾水平的变化，并评估了影响其变化的临床因素。我们检测了311例需要紧急住院的ACS患者在缺血发作期间钾骤降的程度（以ΔK表示，ΔK =出院时的K-入院时的K）。缺血发作期血钾水平较稳定期明显降低（P < 0.001）。多元回归分析显示，发作期血糖水平是唯一与ΔK呈正相关的因素（P < 0.01），而HbA 1c水平与ΔK呈负相关（P < 0.05）。药物特征和肾功能对ΔK无影响。ΔK值越大，住院时间越长，心肌梗死发生率越高，肌酸激酶峰值水平越高。我们已经清楚地表明，有一个短暂的血清钾水平下降，在缺血发作的ACS相比，稳定期。钾下降的程度与葡萄糖水平密切相关，葡萄糖水平压倒了糖尿病的病情，也表明了疾病的严重程度。因此，本研究促进了对ACS患者钾水平与血糖水平平行监测的重要性的认识。
Although a decrease in serum potassium level has been suggested to be a fairly common observation in acute coronary syndrome (ACS), there have so far been no definitive reports directly demonstrating the transient potassium decrease (the potassium dip) during ischemic attack of ACS compared to stable phase in individual patients. To understand the pathophysiological significance of the potassium dip, we examined the changes in serum potassium level throughout ischemic attack and evaluated the clinical factors affecting it. The degree of the potassium dip during ischemic attack (as indicated by ΔK, ΔK = K at discharge − K on admission) was examined in 311 consecutive patients with ACS who required urgent hospitalization in our institution. Serum potassium level during ischemic attack was significantly decreased compared to that during stable phase (P < 0.001). Multiple regression analysis revealed that plasma glucose level during attack was the sole factor which was positively correlated with ΔK (P < 0.01), while HbA1c level was negatively correlated (P < 0.05). The medication profiles and renal function had no impact on ΔK. A longer hospitalization period, higher incidence of myocardial infarction and higher peak creatine kinase level were observed in patients with a larger ΔK. We have clearly demonstrated that there is a transient decrease in serum potassium level during ischemic attack of ACS compared to stable phase. The degree of the potassium dip was tightly correlated with glucose level, which overwhelmed the diabetic condition, and it also indicates the disease severity. The present study therefore promotes awareness of the significance of monitoring potassium level in parallel with glucose level in patients with ACS.
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影响因子：
2.7
作者：
HERLITZ, J;HJALMARSON, A;BENGTSON, A
通讯作者：
BENGTSON, A
影响因子：
39.3
作者：
Ahmed, Ali;Zannad, Faiez;Pitt, Bertram
通讯作者：
Pitt, Bertram
影响因子：
2.2
作者：
RODGER, JC;SIMPSON, E;REID, W
通讯作者：
REID, W
影响因子：
9.6
作者：
Madias, JE;Shah, B;Madias, NE
通讯作者：
Madias, NE
影响因子：
9.3
作者：
Anzawa R;Seki S;Nagoshi T;Taniguchi I;Feuvray D;Yoshimura M
通讯作者：
Yoshimura M