Serum Potassium Levels Inversely Correlate with D-Dimer In Patients with Acute-Onset Atrial Fibrillation

Abstract

BackgroundD-dimer values are frequently increased in patients with atrial fibrillation (AF) compared to subjects in sinus rhythm. Hypokalemia plays a role in several cardiovascular diseases, but little is known about the association with AF.ObjectiveD-dimer values are frequently increased in patients with atrial fibrillation (AF) compared with subjects in sinus rhythm. Hypokalemia plays a role in several cardiovascular diseases, but little is known about the association with AF. The aim of this study was to investigate correlations between D-dimer and serum potassium in acute-onset AF (AAF).MethodsTo investigate the potential correlation between the values of serum potassium and D-dimer in patients with AAF, we retrospectively reviewed clinical and laboratory data of all emergency department visits for AAF in 2013.ResultsAmong 271 consecutive AAF patients with D-dimer assessments, those with hypokalemia (n = 98) had significantly higher D-dimer values than normokalemic patients (139 versus 114 ng/mL, p = 0.004). The rate of patients with D-dimer values exceeding the diagnostic cut-off was higher in the group of patients with hypokalemia than in those with normal serum potassium (26.5% versus 16.2%; p = 0.029). An inverse and highly significant correlation was found between serum potassium and D-dimer (r = −0.21; p < 0.001), even after adjustments for age and sex (beta coefficient −94.8; p = 0.001). The relative risk for a positive D-dimer value attributed to hypokalemia was 1.64 (95% CI, 1.02 to 2.63; p = 0.040). The correlation remained statistically significant in patients free from antihypertensive drugs (r = −0.25; p = 0.018), but not in those taking angiotensin-receptor blockers, angiotensin-converting enzyme inhibitors, or diuretics.ConclusionsThe inverse correlation between values of potassium and D-dimer in patients with AAF provides important and complementary information about the thromboembolic risk of these patients.

Atrial fibrillation due to licorice root syrup

“…Although several previous studies have shown that low serum potassium levels are associated with development of AF, this is a rare occurrence. [9,11,12] We did not find any potential risk factor related with AF except hypokalemia. We considered AF as provoked by low potassium levels resulting from consumption of licorice root syrup.…”

Reversible Takotsubo Syndrome Complicated With Acute Thromboembolic Stroke Co-Occurring With Cola-Induced Severe Hypokalemia

“…Cervellin et al (2014) described an association between hypokalemia and elevated serum levels of D-dimer among patients with acute atrial fibrillation. Accordingly, this association could imply a higher risk of thromboembolism in the setting of hypokalemia [ 14 ]. The diagnosis of atrial fibrillation was neither evident during the presentation of our case nor detected through cardiac telemetry throughout her hospital stay.…”

Strain auricular izquierdo y biomarcadores cardíacos como predictores de accidente cerebrovascular en pacientes con fibrilación auricular de reciente comienzo

“…Se ha reportado que múltiples biomarcadores (BM) asociados a estados protrombóticos, inflamatorios, de stress miocárdico y envejecimiento endotelial, se correlacionan con el aumento del riesgo de ocurrencia, recurrencia y complicaciones de la FA como el ACV 6,7 . Entre éstos se encuentran el Pro-BNP (stress miocárdico)8, Dímero-D (estados protrombóticos) 9 , PCR Ultra sensible (marcador de inflamación) 10 y otros emergentes como GDF-15 que representa un marcador de fibrosis y envejecimiento tisular 11 . Todos los anteriores se asocian directa o indirectamente con mayor riesgo de complicaciones cardiovasculares y se pueden encontrar elevados en pacientes con FA [6][7][8][9][10] .…”

“…Entre éstos se encuentran el Pro-BNP (stress miocárdico)8, Dímero-D (estados protrombóticos) 9 , PCR Ultra sensible (marcador de inflamación) 10 y otros emergentes como GDF-15 que representa un marcador de fibrosis y envejecimiento tisular 11 . Todos los anteriores se asocian directa o indirectamente con mayor riesgo de complicaciones cardiovasculares y se pueden encontrar elevados en pacientes con FA [6][7][8][9][10] . Por otro lado, estudios con ecocardiografía han confirmado que el diámetro auricular izquierdo aumentado, el área auricular izquierda elevada y la disfunción ventricular izquierda se relacionan con una mayor prevalencia de FA y eventos CV 12 .…”