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Publication Information

PubMed ID
Public Release Type
Journal
Publication Year
2024
Affiliation
1, Clinical Research Unit, Khoo Teck Puat Hospital, Singapore 768828; 2, University of Poitiers, INSERM, CHU Poitiers Clinical Investigation Center CIC 1402, Poitiers, France; 3, L’institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France; 4, Saw Swee Hock School of Public Heath, National University of Singapore, Singapore 117549; 5, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232
Authors
Liu J-J, Zheng H, Liu S, Kiu Kwan T, Gurung RL, Chan C, Ang K, de Keizer J, Hadjadj S, Saulnier P-J, Chong M, Chi Lim S
Studies

Abstract

Objective: Data on the relationship between potassium intake and major cardiovascular events (MACE) in patients with diabetes are still scarce. We aim to study the association between estimated potassium intake and risk of MACE in individuals with type 2 diabetes. Methods: Discovery cohort consisted of 1572 participants with type 2 diabetes from a secondary hospital in Singapore. The validation study consisted of 1430 participants with diabetes from Chronic Renal Insufficiency Cohort (CRIC) in the United States. Potassium intake was estimated by urine potassium excretion. The primary outcome was MACE defined as a composite of myocardial infarction, stroke and cardiovascular death. Results: During a median of 8.2 years of follow-up, 341 MACE events were identified in discovery cohort. Compared to low tertile, participants with potassium intake in the upper tertile had 34% lower risk for MACE after adjustment for multiple cardio-renal risk factors (adjusted HR [95% CI], 0.66 [0.49-0.89]). This inverse association was more pronounced in participants with normal to moderately elevated albuminuria (urine creatinine-to-albumin ratio < 300 mg/g) but not in those with severely elevated albuminuria (p for interaction <0.05). In consistence, a higher potassium intake was independently associated with a lower risk for MACE in CRIC participants with diabetes and moderately elevated albuminuria (adjusted HR 0.61 [0.42-0.90], upper versus low terile). Conclusions: A high potassium intake was independently associated with a low risk of MACE. Increasing potassium intake in patients with diabetes may be a potential effective strategy for cardiovascular risk reduction beyond controlling traditional risk factors.