Katsuya Kajimoto1, Yuichiro Minami2, Naoki Sato3, Teruo Takano4. 1. Division of Cardiology, Sekikawa Hospital, Tokyo, Japan. Electronic address: kkajimoto@gmail.com. 2. Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. 3. Internal Medicine, Cardiology, and Intensive Care Unit, Nippon Medical School Musashi-Kosugi Hospital, Kanagawa, Japan. 4. Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Abstract
BACKGROUND: This study investigated the association of a low serum sodium and elevated blood urea nitrogen (BUN) with outcomes in acute decompensated heart failure (HF) patients. METHODS: Of the 4842 patients enrolled in the Acute Decompensated Heart Failure Syndromes (ATTEND) registry, 4438 patients discharged after hospitalization for acute decompensated HF were investigated to assess the association of a low serum sodium and/or elevated BUN at discharge with all-cause mortality. The patients were divided into four groups based on serum sodium (>136 or ≤136mEq/l) and BUN (<25 or ≥25mg/dl) at discharge. The median follow-up period after discharge was 517 (381-776) days. RESULTS: According to multivariate analysis, a low serum sodium (≤136mEq/l) or an elevated BUN (≥25mg/dl) was significantly associated with a higher risk of all-cause death compared with patients who had neither (hazard ratio [HR], 1.53; 95% confidence interval [CI], 1.22 to 1.94; P<0.001 and HR, 1.44; 95% CI, 1.19 to 1.73; P<0.001, respectively). Patients with both low serum sodium and elevated BUN had a higher risk of all-cause death relative to patients with neither (HR, 2.64; 95% CI, 2.17 to 3.20; P<0.001) and also relative to patients with either low serum sodium alone or elevated BUN alone (HR, 1.72; 95% CI, 1.36 to 2.18; P<0.001 and HR, 1.84; 95% CI, 1.53 to 2.21; P<0.001, respectively). CONCLUSION: These findings demonstrated that a low serum sodium and an elevated BUN may be additive risk factors for postdischarge mortality in acute decompensated HF patients.
BACKGROUND: This study investigated the association of a low serum sodium and elevated blood ureanitrogen (BUN) with outcomes in acute decompensated heart failure (HF) patients. METHODS: Of the 4842 patients enrolled in the Acute Decompensated Heart Failure Syndromes (ATTEND) registry, 4438 patients discharged after hospitalization for acute decompensated HF were investigated to assess the association of a low serum sodium and/or elevated BUN at discharge with all-cause mortality. The patients were divided into four groups based on serum sodium (>136 or ≤136mEq/l) and BUN (<25 or ≥25mg/dl) at discharge. The median follow-up period after discharge was 517 (381-776) days. RESULTS: According to multivariate analysis, a low serum sodium (≤136mEq/l) or an elevated BUN (≥25mg/dl) was significantly associated with a higher risk of all-cause death compared with patients who had neither (hazard ratio [HR], 1.53; 95% confidence interval [CI], 1.22 to 1.94; P<0.001 and HR, 1.44; 95% CI, 1.19 to 1.73; P<0.001, respectively). Patients with both low serum sodium and elevated BUN had a higher risk of all-cause death relative to patients with neither (HR, 2.64; 95% CI, 2.17 to 3.20; P<0.001) and also relative to patients with either low serum sodium alone or elevated BUN alone (HR, 1.72; 95% CI, 1.36 to 2.18; P<0.001 and HR, 1.84; 95% CI, 1.53 to 2.21; P<0.001, respectively). CONCLUSION: These findings demonstrated that a low serum sodium and an elevated BUN may be additive risk factors for postdischarge mortality in acute decompensated HF patients.
Authors: Tasnim F Imran; Katherine E Kurgansky; Yash R Patel; Ariela R Orkaby; Robert R McLean; Yuk-Lam Ho; Kelly Cho; J Michael Gaziano; Luc Djousse; David R Gagnon; Jacob Joseph Journal: Int J Cardiol Date: 2019-03-22 Impact factor: 4.164
Authors: Okan Arihan; Bernhard Wernly; Michael Lichtenauer; Marcus Franz; Bjoern Kabisch; Johanna Muessig; Maryna Masyuk; Alexander Lauten; Paul Christian Schulze; Uta C Hoppe; Malte Kelm; Christian Jung Journal: PLoS One Date: 2018-01-25 Impact factor: 3.240