Abstract 18092: The Relationship Between Patency of the Culprit Artery on Admission and Electrolyte Changes in Anterior STEMI - Analysis From the EMBRACE STEMI Clinical Trial

Introduction: During STEMI, the activation of the renin-aldosterone-angiotensin system (RAAS) has a vasoconstrictive effect which may contribute to cardiac ischemia and the final infarct size. Nonetheless, the association between RAAS-related electrolyte changes and the patency of the culprit artery on admission has not been explored. We compared the evolution of RAAS-related electrolyte changes between STEMI patients with occluded LAD vs. patent LAD on admission. Methods: Patients with STEMI of the LAD who were enrolled in the phase 2 EMBRACE STEMI randomized trial with no collateralization in the culprit artery were analyzed (n=271). Culprit artery occlusion was defined as TIMI flow grade ≤1. Results: A total of 140 (51.7%) patients had complete LAD occlusion on admission. The evolution of urinary and serum electrolytes and urinary osmolarity are shown in the figure. Compared with patients with patent LAD, patients with LAD occlusion had significantly lower serum potassium and higher serum sodium concen...