SPC365

Deregulation of potassium homeostasis was a marker of mortality in a cardiovascular disease population

Session: Sessão de Posters 32 - Comportamento, mente e metabolismo
Speaker: Gonçalo Bettencourt Abreu

Congress: CPC 2026
Topic: J. Preventive Cardiology
Theme: 28. Risk Factors and Prevention
Subtheme: 28.3 Secondary Prevention
Session Type: Posters Eletrónicos
FP Number: ---
Authors: Gonçalo Bettencourt Abreu; Maria Isabel Mendonça; Francisco Sousa; Matilde Ferreira; Francisca Escórcio Silva; Mariana Rodrigues; Eva Henriques; Sónia Freitas; A. Cardoso; António Drumond; Ana Célia Sousa; Roberto Palma Dos Reis
<h1 style="text-align:justify"><span style="font-size:20pt"><span style="background-color:white"><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:#2f5496"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">Introduction:</span></span></span></strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black"> Dyskalaemia is a predictor of mortality in sepsis and is associated with higher in-hospital and post-discharge mortality, independent of renal function and illness severity. Dyskalemia causes<span style="background-color:white"> abnormal impulse generation and conduction in the heart, which can be fatal</span><span style="background-color:white">.</span> Whether it is an independent marker of mortality in cardiovascular (CV) disease is under </span></span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">investigation.</span></span></span></span></span></span></span></h1>

<h1 style="text-align:justify"><span style="font-size:20pt"><span style="background-color:white"><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:#2f5496"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">Objective:</span></span></span></strong> <span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">To investigate whether potassium (K) levels above or below the optimal threshold are associated with increased all-cause and CV mortality in individuals with established atherosclerotic CV disease, </span></span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">with an extended follow-up. </span></span></span></span></span></span></span></h1>

<h1 style="text-align:justify"><span style="font-size:20pt"><span style="background-color:white"><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:#2f5496"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">M&eacute;todos:</span></span></span></strong> <span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">We analyzed 1,720 patients with cardiovascular disease to assess all-cause and cardiovascular mortality according to K thresholds over 7.6 &plusmn; 6.7 years of follow-up.</span></span></span> <span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">The population-specific optimal K cutoff value was identified using the Youden J index derived from ROC curve analysis. </span></span></span><span style="font-size:11.0pt"><span style="background-color:white"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">Kaplan-Meier analysis evaluated survival, and Cox regression assessed the independent variables associated with all-cause and CV mortality. </span></span></span></span></span></span></span></span></h1>

<h1 style="text-align:justify"><span style="font-size:20pt"><span style="background-color:white"><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:#2f5496"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">Results:</span></span></span></strong><span style="font-size:11.0pt"><span style="background-color:white"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black"> For all-cause mortality (n=550),</span></span></span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black"> 52.9% presented a cutoff point K<span style="background-color:white">&gt;4.51, and 77.8% showed a cutoff point K&gt;4.3 for CV mortality (n=361).</span> </span></span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">The Kaplan-Meier curves for all-cause and CV mortality indicated that patients with K above the cutoff had a higher event rate throughout follow-up. Specifically, at the end of 10 years, the event probability was 32.1% vs 26.5% for the all-cause group (p=0.012), and the same was observed for CV mortality,</span></span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black"> with 23.2% vs 12.5% (p=0.005). For all-cause mortality, </span></span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">after adjusting for confounding variables (traditional risk factors and chronic kidney disease [CKD]), the Cox regression showed that K levels above and below the cut point remained in the equation (OR=1.193 and OR=0.838; p=0.041, respectively), together with smoking, diabetes, and hypertension. For CV mortality, it is likewise an independent predictor above and below K levels (OR=1.387 and OR=0.721; p=0.010, respectively), together with smoking and diabetes. </span></span></span></span></span></span></span></h1>

<p style="text-align:justify"><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Conclusion:</span></strong><span style="color:black"> In this study, diskalemia (hyper and hypokalemia) is associated with mortality. However, hyperkalemia had a worse prognosis, being more relevant in CV mortality. This association persists <strong><span style="font-family:&quot;Calibri&quot;,sans-serif">even after adjustment for CKD and traditional risk factors, supporting the view that</span></strong> potassium homeostasis is a meaningful independent biomarker of CV and all-cause mortality. </span><span style="color:#212121">On the other hand, normal kalemia was protective, with a significant OR&lt;1.</span></span></span></span></p>