Trial reportEuropean heart journal. Acute cardiovascular care2017
Serum potassium levels, cardiac arrhythmias, and mortality following non-ST-elevation myocardial infarction or unstable angina: insights from MERLIN-TIMI 36.
Trial report in European heart journal. Acute cardiovascular care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.
- Potassium levels and the risk of all-cause and cardiovascular mortality among patients with cardiovascular diseases: a meta-analysis of cohort studies.Nutrition journal · 2024Pooled it
- Development and Validation of Machine Learning-Based Models to Predict In-Hospital Mortality in Life-Threatening Ventricular Arrhythmias: Retrospective Cohort Study.Journal of medical Internet research · 2023Trial
- Plasma Omega-3 Fatty Acids and the Risk of Cardiovascular Events in Patients After an Acute Coronary Syndrome in MERLIN-TIMI 36.Journal of the American Heart Association · 2021Trial
- Trial
- Dynamic Variability of Sodium and Potassium Predicts Mortality in Critically Ill Patients With Ischemic Stroke: Evidence From Two Critical Care Cohorts.Brain and behavior · 2026Article
- Synergistic Effects of Normal-Range Serum Sodium and Potassium on Mortality: The Modifying Role of Inflammation From a NHANES Cohort Analysis.Chronic diseases and translational medicine · 2026Article
- Impact of postoperative serum potassium levels and variability on 1-year mortality rate in coronary artery bypass grafting patients: a retrospective cohort study.Journal of cardiothoracic surgery · 2026Article
- Factors Associated with Arrhythmia in Patients with ST Segment Elevation Myocardial Infarction: A Single-Center Cross-Sectional Study.Research in heart yield and translational medicine · 2026Article
- Heart failure risk prediction based on machine learning and interpretability analysis.Frontiers in medicine · 2026Article
- Machine learning prediction and SHAP interpretability analysis of heart failure risk in patients with hyperuricemia.Frontiers in cardiovascular medicine · 2025Article
- Depression among older adults who developed acute coronary syndrome (ACS) during hospitalization for non-cardiac illness: A prospective observational study.Journal of family medicine and primary care · 2024Article
- Effects of Serum Potassium on Mortality in Patients With ST-Elevation Myocardial Infarction.Cureus · 2024Article
- Replacing Potassium in the Emergency Department May Not Decrease the Hospital Mortality in Mild Hypokalemia: A Propensity Score Matching Analysis.Medicina (Kaunas, Lithuania) · 2023Article
- Clinical outcomes of serum potassium in patients with percutaneous coronary intervention: insights from a large single-center registry.Frontiers in cardiovascular medicine · 2023Article
- Association of Serum Potassium Levels with Mortality and Cardiovascular Events: Findings from the Chinese Multi-provincial Cohort Study.Journal of general internal medicine · 2022Article
- Evaluation of the Relationship Between Changes in Potassium Concentration and Arrhythmia During Coronary Artery Bypass Grafting Surgery.Anesthesiology and pain medicine · 2022Article
- One-year survival cohort of patients with reduced ejection fraction heart failure in Iranian population: A single center study.ARYA atherosclerosis · 2021Article
- Potassium variability during hospitalization and outcomes after discharge in patients with acute myocardial infarction.Journal of geriatric cardiology : JGC · 2021Article
- Article
- Association Between Average Plasma Potassium Levels and 30-day Mortality During Hospitalization in Patients with COVID-19 in Wuhan, China.International journal of medical sciences · 2021Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundIn acute coronary syndrome (ACS), potassium levels <3.5 mEq/L are associated with ventricular arrhythmias. Current guidelines therefore recommend a potassium target >4.0 mEq/L in ACS. Our study evaluated the association between potassium levels, cardiac arrhythmias, and cardiovascular death in patients with non-ST-segment elevation myocardial infarction or unstable angina.
methodsPotassium levels were measured in 6515 patients prior to randomization to receive either ranolazine or a placebo in the MERLIN-TIMI 36 trial. A seven-day continuous electrocardiographic assessment was obtained to determine the incidence of non-sustained ventricular tachycardia (NSVT) and ventricular pauses. The association between potassium levels and cardiovascular death was evaluated using a Cox proportional hazards regression model with multivariable adjustment.
resultsNSVT lasting for at least eight consecutive beats occurred more frequently at potassium levels <3.5 mEq/L than at potassium levels ⩾5 mEq/L (10.1 vs. 4.5%, p=0.03 for trend), whereas the inverse pattern was observed for ventricular pauses >3 s, which occurred more frequently at potassium levels ⩾5 mEq/L than at potassium levels <3.5 mEq/L (5.9 vs. 2.0%, p=0.03 for trend). There was a U-shaped relationship between the potassium level at admission and both early and late risk of cardiovascular death. Compared with patients with potassium levels of 3.5 to <4 mEq/L, a potassium level <3.5 mEq/L was associated with an increased risk of cardiovascular death at day 14 (2.4 vs. 0.8%, HR
conclusionsThe lowest risk of cardiovascular death was observed in patients with admission potassium levels between 3.5 and 4.5 mEq/L. Both lower and higher levels of potassium were associated with tachyarrhythmias and bradyarrhythmias, suggesting a potential mechanistic explanation for the increased risk of cardiovascular death at the extremes of potassium homeostasis.
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