Variations in Post-Operative Electrolyte in Coronary Artery Intervention

Abstract

Qian Fan,1,* Zhongmei Bai,2,* Fabrice Yves Ndjana Lessomo,3,* Bingqing Dong,1 Weiqin Zhong,1 Fenglin Jin,1 Zhiquan Wang3 1Department of Cardiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong Province, People’s Republic of China; 2Department of Cardiology, The People’s Hospital of Huangmei, Huanggang, Hubei Province, People’s Republic of China; 3Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhiquan Wang; Fenglin Jin, Email [email protected]; [email protected]: Low volume change and minimal trauma observed during angiography are the reason why physicians often overlook any changes affecting pre-operative electrolytes levels after coronary intervention. However, few studies have addressed the issue of electrolyte changes after the coronary intervention. Therefore, our study investigates coronary angiography’s effect on electrolytes and provides the quick identification of groups more prone to electrolyte changes.Methods: From the department of cardiology of the second affiliated hospital of Shandong’s first medical university, 374 patients undergoing coronary angiography were selected. Pre-intervention and post-intervention serums, sodium (Na+), potassium (K+), chloride (Cl−), magnesium (Mg2+) and renal function were analyzed. The correlation between influential factors was also assessed. The association of hypokalemia with short-major adverse cardiac events (MACE) and arrhythmia was evaluated.Results: Among the 374 subjects including 264 patients who had a simple angiography and 110 patients who received coronary artery interventional therapy. A decrease in potassium levels was found in 81.8% of the patients, and post-interventional hypokalemia was observed in 15.0%. After the intervention, the hypokalemia among males was 2.18 times than that of females, and the pre-operative serum potassium level was 3.5mmol/L≤K+< 4.0mmol/L and was 2.09 times than that of K+≥ 4.0 mmol/L, but was not associated with age and either simple coronary angiography or PCI (percutaneous coronary intervention). Hypernatremia was also prevalent in males under 60 years and with pre-operative hypernatremia. Significant variations were found between hypokalemia and influential factors like hypertension, diabetes, and gastrointestinal disease. We also found that there was no obvious correlation between hypokalemia and recurrent angina, heart failure and death, but significantly increased the risk of some arrhythmias.Conclusion: Male patients are more likely to suffer from electrolyte disturbance after coronary intervention. There is a need to emphasize monitoring and managing electrolyte changes to prevent severe complications in the peri-operative period.Keywords: coronary angiography, electrolytes, hypokalemia, hypernatremia, risk factors

Keywords

• coronary angiography
• electrolytes
• hypokalemia
• hypernatremia
• risk factors