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Horm Metab Res 2006; 38(3): 197-202
DOI: 10.1055/s-2006-925224
Original Clinical
© Georg Thieme Verlag KG Stuttgart · New York

Acute Vascular Events and Electrolytes Variations in Elderly Patients

A.  Solini1 , P.  Zamboni2 , A.  Passaro2 , R.  Fellin2 , E.  Ferrannini1, 3
  • 1Department of Internal Medicine University of Pisa, Italy
  • 2Department of Clinical and Experimental Medicine, Section of Internal Medicine II, University of Ferrara, Italy
  • 3CNR Institute of Clinical Physiology Pisa, Italy
Further Information

Publication History

Received 15 June 2005

Accepted after revision 3 January 2006

Publication Date:
27 April 2006 (online)

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Abstract

Alterations in electrolyte balance have been claimed to play a role in the pathophysiology of coronary heart disease; however, the relationship between the electrolyte pattern and other clinical variables immediately after an acute vascular event is unclear. The aim of the present study was to test whether electrolyte and microelement changes characterize the acute phase in patients with different degrees of glucose tolerance admitted to the hospital shortly after an acute cardiovascular or cerebrovascular ischemic event. Two hundred consecutive patients with either myocardial infarction or stroke (SP group), stratified by degree of glucose tolerance, were studied within six hours of admission, and compared against 125 patients admitted for conditions other than acute vascular ischemia (CP). Routine laboratory parameters and serum Na, K, Cl, Mg and Ca concentrations were determined in all patients and compared to those recorded within six months before the admission. Relative to CP and independently of confounding factors including glucose tolerance status, the SP group showed significantly higher plasma glucose and insulin concentrations, higher creatinine and a modified serum electrolyte pattern characterized by significantly lower potassium and magnesium levels and by hypercalcemia and hyperphosphatemia. Irrespective of glucose tolerance, the first hours following an acute vascular event are characterized by marked insulin resistance with a consistent shift in the serum electrolyte pattern. This pattern is the physiological consequence of the attendant compensatory hyperinsulinemia. Its significance for the evolution of ischemic damage remains to be established.

Key words

Myocardial infarction - stroke - electrolytes - insulin - kidney function

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Anna Solini, M. D.

Department of Internal Medicine · Section of Internal Medicine III

Via Roma, 67 · 56100 Pisa · Italy

Phone: +39 (050) 99 34 82

Fax: +39 (050) 55 32 35

Email: a.solini@med.unipi.it