Early versus delayed potassium correction and in-hospital outcomes in patients with acute myocardial infarction: a prospective observational study

Abstract

Introduction. Acute myocardial infarction (AMI) often presents with electrolyte disturbances, particularly abnormalities in serum potassium, which can significantly affect cardiac electrophysiology. Timely correction of potassium abnormalities may improve clinical outcomes. The aim of this study was to compare prognostic outcomes according to the timing of potassium correction in patients with dyskalemia complicating acute myocardial infarction. Materials and methods. A prospective observational study was conducted at Saveetha Medical College and Hospital involving 100 patients with AMI aged >18 years, excluding those with stage 4 or 5 chronic kidney disease (CKD) or receiving potassium-altering medications. Patients underwent serial serum potassium monitoring during hospitalization. Patients who developed dyskalemia were classified according to the interval between the first laboratory detection of dyskalemia and initiation of potassium correction therapy into an early correction group (within 2 hours) and a delayed correction group (more than 2 hours). Statistical analysis was performed using the chi-square test or Fisher’s exact test, as appropriate, and the independent-samples Student’s t-test. Results. Of 100 patients, 55 underwent early potassium correction and 45 underwent delayed correction. Early correction was associated with a significantly lower incidence of arrhythmias (12.7% vs. 31.1%, p = 0.029) and a shorter hospital stay (5.3 ± 1.5 vs. 7.0 ± 2.0 days, p < 0.001). Although cardiac arrest, acute heart failure, ICU admission, and in-hospital mortality were numerically lower in the early correction group, these differences were not statistically significant. Conclusion. Potassium correction within 2 hours of the first laboratory detection of dyskalemia was associated with fewer documented arrhythmias and a shorter hospital stay in patients with AMI. No statistically significant differences were observed in cardiac arrest, acute heart failure, ICU admission, or in-hospital mortality.