Relation of serum electrolytes and left ventricular functions in patients with STEMI undergoing primary PCI

Electrolyte disturbances are common in STEMI patients. However, the association between admission serum electrolyte levels and echocardiographic findings after primary percutaneous coronary intervention (PPCI) remains incompletely understood. This study investigated the relationship between serum electrolyte levels, echocardiographic parameters, angiographic findings, and ST-segment resolution (STR) in patients with first anterior STEMI. In this observational study, 138 patients with first anterior STEMI undergoing PPCI were enrolled. Admission serum sodium, potassium, magnesium, total calcium, and ionized calcium levels were measured. Before hospital discharge, transthoracic echocardiography was performed to evaluate left ventricular ejection fraction (LVEF), regional wall motion abnormality index (RWMAI), and left ventricular end-systolic volume index (LVESVI). Angiographic findings and STR were also assessed. Multivariable logistic regression was performed after adjustment for age and sex. Results at an exploratory level, lower serum potassium was associated in age- and sex-adjusted analyses with reduced LVEF (aOR = 2.984, 95% CI: 1.285–6.926; P = 0.011) and increased RWMAI (OR = 3.103, 95% CI: 1.338–7.196; P = 0.008); and patients with ionized calcium ≥ 1.05 mmol/L demonstrated significantly greater STR than those with lower levels ( P = 0.028). Serum sodium, magnesium, total calcium, and ionized calcium were not significantly associated with echocardiographic parameters. After Bonferroni correction for multiple comparisons, none of the observed associations remained statistically significant. Admission lower serum potassium is suggested to be associated with impaired left ventricular systolic function and more extensive RWMAI in patients with first anterior STEMI undergoing PPCI. However, these associations should be considered exploratory, particularly given the multiple electrolyte-outcome comparisons and the lack of statistical significance after Bonferroni correction.