Electrolyte Levels May Predict Outcomes in Ischemic Stroke, reveals research

Ischemic stroke is the most common cause of death and disability globally, and the determination of prognostic factors is important for enhancing patient outcomes. Although elevated serum potassium, calcium, and magnesium have been linked with lower risk of ischemic stroke, their role in stroke prognosis is unknown. To inform this, a study was undertaken based on the Minhang Stroke Cohort data, examining the relationship between the serum electrolytes and stroke outcomes.

The analysis involved data from 5,469 patients with ischemic stroke in the Minhang Stroke Cohort. Baseline serum levels of potassium, calcium, and magnesium were measured. The main outcome was a composite of mortality and severe disability (modified Rankin Scale score ≥3) at 3 months after stroke. Secondary outcomes were mortality, severe disability, and the ordered 7-level modified Rankin Scale score. Associations were measured using multivariate models adjusted for potential confounders.

Results

At the 3-month follow-up, 1,834 patients had the primary outcome. With adjustment for confounders, patients in the highest quartile of serum electrolytes had significantly reduced risks of adverse outcomes relative to those in the lowest quartile:

• Potassium: aOR 0.79 (95% CI, 0.68–0.93; P=0.007).

• Calcium: aOR 0.69 (95% CI, 0.58–0.82; P<0.001).

• Magnesium: aOR 0.83 (95% CI, 0.70–0.99; P=0.015).

Multivariable-adjusted restricted cubic spline analysis demonstrated linear dose-response relations between each of the electrolytes and favorable outcomes.

The results suggest that it is beneficial to maintain high-normal serum levels of potassium, calcium, and magnesium to have a favorable effect on outcome after ischemic stroke. These electrolytes are potential valuable prognostic biomarkers to influence clinical practice and interventions toward favorable patient prognosis.

High-normal serum levels of potassium, calcium, and magnesium were associated with decreased risks of unfavorable outcomes at 3 months after stroke. These results indicate the potential utility of these electrolytes as prognostic biomarkers for the management of ischemic stroke, highlighting the value of monitoring and ensuring optimal levels of these electrolytes in patients with stroke.

Reference:

Quan Yu, MD*; Yang Liu, MDhttps://orcid.org/0000-0001-5939-572X*; Xinyue Chang, MD*; Xueyu Mao, MDhttps://orcid.org/0000-0001-6143-197X; Xuechun Wu, MD; Min Chu, MD; Huicong Niu, MD, PhDhttps://orcid.org/0000-0001-9112-8883; Mengyao Shi, MD, PhD; Lulu Sun, MD; Yu He, MD; Yi Liu, MD; Daoxia Guo, MD, PhD; Zhengbao Zhu, MD, PhDhttps://orcid.org/0000-0001-5500-0014; Jing Zhao, MD, PhDhttps://orcid.org/0000-0001-5197-9181. High‐Normal Serum Potassium, Calcium, and Magnesium Levels Are Associated With Decreased Risks of Adverse Outcomes After Ischemic Stroke, Journal of the American Heart Association, 2025.