BACKGROUND: The incidence of congestive heart failure (CHF) has not significantly declined over the past 50 years, and overall survival rates are low at 5 years following diagnosis. Numerous studies have shown low serum sodium to be a poor prognostic indicator of all cause mortality in CHF patients. HYPOTHESIS: The goal of this hypothesis was to validate if hyponatremia is an important predictor of mortality in an outpatient population of CHF patients on maximal combined angiotensin-converting enzyme inhibitor (ACEI) and β-blocker therapy. METHODS: A total of 364 (13% with hyponatremia) patients with CHF (ejection fraction [EF] ≤ 40%) were enrolled in a heart failure disease management program. The mean New York Heart Association (NYHA) class was II.XII. The average baseline serum sodium was 138.2 mEq/L. RESULTS: We evaluated the relationship between hyponatremia (<135 mEq/L) and all-cause mortality at 40 months. During follow-up, 8 patients in the hyponatremia group compared to 31 in the normonatremic group died. Results of Kaplan-Meier analyses indicated there were no significant differences in mortality between the hyponatremia and normonatremic groups (log-rank test = 0.39). Results for Cox proportional hazards models indicated low sodium was not a significant predictor of mortality (unadjusted odds ratio [OR]: 1.41, 95% confidence interval [CI]: 0.65, 3.07; adjusted OR: 1.60, 95% CI: 0.57, 4.53). CONCLUSIONS: The relationship between hyponatremia and all-cause mortality did not reach significance. Hyponatremia did not significantly predict mortality in a CHF population on maximal medical therapy.
BACKGROUND: The incidence of congestive heart failure (CHF) has not significantly declined over the past 50 years, and overall survival rates are low at 5 years following diagnosis. Numerous studies have shown low serum sodium to be a poor prognostic indicator of all cause mortality in CHFpatients. HYPOTHESIS: The goal of this hypothesis was to validate if hyponatremia is an important predictor of mortality in an outpatient population of CHFpatients on maximal combined angiotensin-converting enzyme inhibitor (ACEI) and β-blocker therapy. METHODS: A total of 364 (13% with hyponatremia) patients with CHF (ejection fraction [EF] ≤ 40%) were enrolled in a heart failure disease management program. The mean New York Heart Association (NYHA) class was II.XII. The average baseline serum sodium was 138.2 mEq/L. RESULTS: We evaluated the relationship between hyponatremia (<135 mEq/L) and all-cause mortality at 40 months. During follow-up, 8 patients in the hyponatremia group compared to 31 in the normonatremic group died. Results of Kaplan-Meier analyses indicated there were no significant differences in mortality between the hyponatremia and normonatremic groups (log-rank test = 0.39). Results for Cox proportional hazards models indicated low sodium was not a significant predictor of mortality (unadjusted odds ratio [OR]: 1.41, 95% confidence interval [CI]: 0.65, 3.07; adjusted OR: 1.60, 95% CI: 0.57, 4.53). CONCLUSIONS: The relationship between hyponatremia and all-cause mortality did not reach significance. Hyponatremia did not significantly predict mortality in a CHF population on maximal medical therapy.
Authors: Daniel Levy; Satish Kenchaiah; Martin G Larson; Emelia J Benjamin; Michelle J Kupka; Kalon K L Ho; Joanne M Murabito; Ramachandran S Vasan Journal: N Engl J Med Date: 2002-10-31 Impact factor: 91.245
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Authors: Jeremy A Miles; Renato Quispe; Yonatan Mehlman; Kavisha Patel; Claudia Lama Von Buchwald; Jee Young You; Seth Sokol; Robert T Faillace Journal: PLoS One Date: 2019-06-19 Impact factor: 3.240
Authors: Giovanni Corona; Corinna Giuliani; Gabriele Parenti; Dario Norello; Joseph G Verbalis; Gianni Forti; Mario Maggi; Alessandro Peri Journal: PLoS One Date: 2013-12-18 Impact factor: 3.240