ArticleHeart (British Cardiac Society)2003
Effect of diabetes on serum potassium concentrations in acute coronary syndromes.
Article in Heart (British Cardiac Society), 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 23 citations in OpenAlex.
- Mechanisms of Diabetic Nephropathy Not Mediated by Hyperglycemia.Journal of clinical medicine · 2023Review
- Article
- Potassium concentration on admission is an independent risk factor for target lesion revascularization in acute myocardial infarction.TheScientificWorldJournal · 2014Article
- Transient decrease in serum potassium level during ischemic attack of acute coronary syndrome: paradoxical contribution of plasma glucose level and glycohemoglobin.Cardiovascular diabetology · 2013Article
- Hypokalemia and sudden cardiac death.Experimental and clinical cardiology · 2010Article
- Difficulties in maintaining potassium homeostasis in patients with heart failure.Clinical cardiology · 2006Review
- Declining case fatality rates for acute myocardial infarction in South Asian and white patients in the past 15 years.Heart (British Cardiac Society) · 2006Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo compare serum potassium concentrations in diabetic and non-diabetic patients in the early phase of acute coronary syndromes.
backgroundAcute phase hypokalaemia occurs in response to adrenergic activation, which stimulates membrane bound sodium-potassium-ATPase and drives potassium into the cells. It is not known whether the hypokalaemia is attenuated in patients with diabetes because of the high prevalence of sympathetic nerve dysfunction.
methodsProspective cohort study of 2428 patients presenting with acute coronary syndromes. Patients were stratified by duration of chest pain, diabetic status, and pretreatment with beta blockers.
resultsThe mean (SD) serum potassium concentration was significantly higher in diabetic than in non-diabetic patients (4.3 (0.5) v 4.1 (0.5) mmol/l, p < 0.0001). Multivariate analysis identified diabetes as an independent predictor of a serum potassium concentration in the upper half of the distribution (odds ratio 1.66, 95% confidence interval 1.38 to 2.00). In patients presenting within 6 hours of symptom onset, there was a progressive increase in plasma potassium concentrations from 4.08 (0.46) mmol/l in patients presenting within 2 hours, to 4.20 (0.47) mmol/l in patients presenting between 2-4 hours, to 4.24 (0.52) mmol/l in patients presenting between 4-6 hours (p = 0.0007). This pattern of increasing serum potassium concentration with duration of chest pain was attenuated in patients with diabetes, particularly those with unstable angina. Similar attenuation occurred in patients pretreated with beta blockers.
conclusionIn acute coronary syndromes, patients with diabetes have significantly higher serum potassium concentrations and do not exhibit the early dip seen in non-diabetics. This may reflect sympathetic nerve dysfunction that commonly complicates diabetes.
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