The relationship between serum potassium levels and cardiac arrhythmias in left ventricular assist device (LVAD) recipients: a comprehensive analysis and prognostic evaluation.
Clin Res Cardiol
; 2024 Aug 27.
Article
in En
| MEDLINE
| ID: mdl-39191952
ABSTRACT
BACKGROUND:
This study aimed to comprehensively analyze the relationship between serum potassium (K+) levels and the risk of de novo cardiac arrhythmias in left ventricular assist device (LVAD) recipients.METHODS:
We performed a retrospective study using the INTERMACS registry. Data was collected on adult patients with available K+ measurements taken 1-month post-LVAD implantation. K+ levels were the main exposure of interest and were analyzed as a continuous and categorical variable (quartiles of baseline K+ distribution). The main outcome of interest was the occurrence of de novo arrhythmia events, either sustained (ventricular [VA] or supraventricular arrhythmia [SVA]) or not sustained (atrial fibrillation/flutter [AF]). All-cause mortality was evaluated as the secondary outcome. Multivariable adjusted time-dependent Cox regression models and natural splines were used to describe the relationship between the exposure and outcomes of interest.RESULTS:
10,570 patients met our inclusion criteria. A significant and consistent relationship was observed between the lowest quartile of longitudinal K+ and the risk of arrhythmic events (HR 1.28, 95% CI 1.08, 1.53, p = 0.005) as well as in the highest K+ quartile (HR 1.24, 95% CI 1.02, 1.49, p = 0.027). A similar relationship was confirmed in the stratified analysis of arrhythmia types for SVAs and AF. The data were reflected in a U shaped relationship. Similarly, the highest and lowest quartiles of longitudinal K+ were independently associated with a significant increase in the HR of death, which was reflected by a U shaped relationship.CONCLUSIONS:
Our study reveals a significant U shaped relationship between low and high K + levels and cardiac arrhythmias in LVAD patients, particularly SVAs and AF. Both high and low K + levels negatively impacted patient survival.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
Clin Res Cardiol
Journal subject:
CARDIOLOGIA
Year:
2024
Document type:
Article
Affiliation country: