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首页> 外文期刊>European journal of preventive cardiology >Association of serum potassium concentration with mortality and ventricular arrhythmias in patients with acute myocardial infarction: A systematic review and meta-analysis
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Association of serum potassium concentration with mortality and ventricular arrhythmias in patients with acute myocardial infarction: A systematic review and meta-analysis

机译：急性心肌梗死患者死亡率和心间隙性血清钾浓度与急性心肌梗死患者的关系：系统评价和荟萃分析

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Background Challenging clinical practice guidelines that recommend serum potassium concentration between 4.0–5.0?mEq/L or ≥4.5?mEq/L in patients with acute myocardial infarction, recent studies found increased mortality risks in patients with a serum potassium concentration of ≥4.5?mEq/L. Studies investigating consequences of hypokalemia after acute myocardial infarction revealed conflicting results. Therefore, the aim of this systematic review and meta-analysis was to combine evidence from previous studies on the association of serum potassium concentration with both short and long-term mortality as well as the occurrence of ventricular arrhythmias. Design Systematic review and meta-analysis. Methods A structured search of MEDLINE and EMBASE databases yielded 23 articles published between 1990 and January 2017 that met the inclusion criteria. Study selection, data extraction and quality assessment were carried out by three reviewers. Random effects models were used to pool estimates across the included studies and sensitivity analyses were performed when possible. Results Twelve studies were included in the meta-analysis. Both pooled results from six studies investigating short-term mortality and from five studies examining long-term mortality revealed significantly increased risks in patients with serum potassium concentrations of <3.5?mEq/L, 4.5–<5.0?mEq/L and ≥5.0?mEq/L after acute myocardial infarction. In addition, a serum potassium concentration of <3.5?mEq/L was significantly associated with the occurrence of ventricular arrhythmias. Conclusions Mortality, both short and long term, and the occurrence of ventricular arrhythmias in patients with acute myocardial infarction seem to be negatively associated with hypokalemic serum potassium concentration. There is evidence for adverse consequences of serum potassium concentrations of ≥4.5?mEq/L. Due to the heterogeneity among existing studies, further research is necessary to confirm the need to change clinical practice guidelines.
机译：背景技术挑战临床实践指南，推荐血清钾浓度4.0-5.0？MEQ / L或≥4.5？MEQ / L在急性心肌梗死患者中，最近的研究发现患者血清钾浓度≥4.5的患者的死亡率风险增加/ l。急性心肌梗死后低钾血症患者揭示突破性的结果研究。因此，这种系统审查和荟萃分析的目的是将来自先前研究的证据与血清钾浓度结合的证据结合在短期和长期死亡率以及心律失常的发生。设计系统评论和荟萃分析。方法采用MEDLINE和EMBASE数据库的结构化搜索产生了23篇1990年至2017年1月至2017年1月的文章，符合纳入标准。学习选择，数据提取和质量评估由三名审稿人进行。随机效果模型用于池估计在内的研究中，并且在可能的情况下进行敏感性分析。结果在Meta分析中包含12项研究。来自六项研究的合并结果调查短期死亡率和五项研究检查长期死亡率揭示血清钾浓度的患者的风险显着增加<3.5？MEQ / L，4.5- <5.0？MEQ / L和≥5.0？急性心肌梗死后Meq / L.此外，血清钾浓度<3.5？Meq / L与脑室心律失常的发生显着相关。结论急性心肌梗死患者短期和长期的死亡率，以及急性心肌梗死患者心律失常的发生似乎与低钾血清钾浓度负相关。有证据表明血清钾浓度的不良后果≥4.5？meq / l。由于现有研究中的异质性，有必要进行进一步的研究，以确认需要改变临床实践指南的必要性。

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