ArticleReviews in cardiovascular medicine2026
Baseline Serum Potassium Within the Normal Range Is Independently Associated With One-Year Myocardial Strain Recovery in Patients With ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention: A Cardiac Magnetic Resonance Study.
Article in Reviews in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: While serum potassium abnormalities predict mortality in acute myocardial infarction, whether potassium levels within the normal range influence long-term myocardial functional recovery remains unknown. Therefore, this study aimed to investigate the association between baseline potassium levels and 1-year cardiac magnetic resonance (CMR)-derived global longitudinal strain in patients with ST-segment elevation myocardial infarction (STEMI). Methods: This retrospective cohort study enrolled 120 consecutive patients with STEMI (mean age 52.4 ± 12.6 years, 94.2% male) who underwent primary percutaneous coronary intervention (PCI) and completed 1-year CMR follow-up. Baseline electrolyte levels, including potassium, sodium, chloride, magnesium, ionized calcium, and phosphorus, were measured before the intervention. The primary outcome was 1-year absolute global longitudinal strain (abs_GLS) assessed by CMR feature tracking. Analysis of covariance (ANCOVA) was used to evaluate associations between electrolyte levels and myocardial strain after adjustment for baseline abs_GLS and 16 clinical covariates, including discharge medications. Results: Baseline potassium averaged 3.92 ± 0.26 mmol/L, with 90% of values ranging from 3.42 to 4.39 mmol/L. After adjustment for baseline abs_GLS and 16 clinical covariates, potassium was the only electrolyte significantly associated with 1-year abs_GLS in the prespecified primary model. Each 1-SD increase in potassium (0.26 mmol/L) was associated with a 0.782 percentage-point higher 1-year abs_GLS (95% CI: 0.042-1.521, Conclusions: Among patients with STEMI treated with primary PCI, baseline serum potassium, even within the normal range, is independently associated with 1-year myocardial strain recovery, with a trend toward superior outcomes at higher-normal levels. These findings suggest that potassium may serve as a readily available prognostic biomarker for risk stratification; nonetheless, randomized trials are warranted to investigate whether targeted optimization of potassium can improve post-infarction cardiac recovery.
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