IN a major new prospective study examining ischemic stroke prognosis, researchers have found that patients with high-normal serum levels of potassium, calcium, and magnesium experienced significantly lower risks of death or major disability at 3 months. This research adds new dimension to the role of common electrolytes as potential prognostic biomarkers in post-stroke care.
The study, based on data from 5469 ischemic stroke patients in the Minhang Stroke Cohort, measured baseline serum electrolyte levels and followed participants for 3 months. The primary outcome assessed was a composite of death or major disability, defined as a modified Rankin Scale score of 3 or higher.
Findings published ahead of print in the Journal of the American Heart Association revealed clear associations between elevated—yet still within normal range—electrolyte levels and improved stroke outcomes. After multivariate adjustment, patients in the highest quartiles of potassium, calcium, and magnesium levels had significantly reduced odds of poor outcomes compared to those in the lowest quartiles.
Specifically, the adjusted odds ratio (aOR) for potassium was 0.79 (95% CI, 0.68–0.93; Ptrend = 0.007), for calcium 0.69 (95% CI, 0.58–0.82; Ptrend < 0.001), and for magnesium 0.83 (95% CI, 0.70–0.99; Ptrend = 0.015). Notably, multivariable-adjusted restricted cubic spline models showed a linear, dose-response relationship between each electrolyte and the risk of the composite outcome (all P for linearity < 0.05). These results suggest that maintaining electrolyte levels at the higher end of the normal range may contribute to better functional outcomes after ischemic stroke. The findings could have implications for early post-stroke lab monitoring and risk stratification, although further research is needed before clinical recommendations can be made. Reference: Quan Y et al. High-Normal Serum Potassium, Calcium, and Magnesium Levels Are Associated With Decreased Risks of Adverse Outcomes After Ischemic Stroke. J Am Heart Assoc. 2025; e037601.
