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. 2010 Dec;33(12):E13-7.
doi: 10.1002/clc.20560. Epub 2010 Nov 22.

Low serum sodium as a poor prognostic indicator for mortality in congestive heart failure patients

Andrew DeWolfe  1 , Barbara Lopez, Lee M Arcement, Kathy Hebert
Affiliations

Low serum sodium as a poor prognostic indicator for mortality in congestive heart failure patients

Andrew DeWolfe et al. Clin Cardiol. 2010 Dec.

Abstract

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. Copyright © 2010 Wiley Periodicals, Inc.

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Figures

Figure 1
Figure 1
Survival at 40 months of patients with low sodium (hyponatremia) and patients with normal sodium (P = 0.39, log‐rank test)
See this image and copyright information in PMC

References

    1. American Heart Association. Heart Disease and Stroke Statistics—2008 Update. Dallas, Texas: American Heart Association; 2008. © 2008, American Heart Association.
    1. Ho KK, Anderson KM, Kannel WB, Grossman W, Levy D. Survival after the onset of congestive heart failure in Framingham Heart Study subjects. Circulation 1993; 88: 107–115. - PubMed
    1. Levy D, Kenchaiah S, Larson MG, et al. Long‐term trends in the incidence of and survival with heart failure. N Engl J Med 2002; 347(18): 1397–1402. - PubMed
    1. Kannel, WB. Incidence and epidemiology of heart failure. Heart Failure Review 2000; 5(2): 167–173. - PubMed
    1. Lee WH, Packer M. Prognostic importance of serum sodium concentration and its modification by converting‐enzyme inhibition in patients with severe chronic heart failure. Circulation 1986; 73(2): 257–267. - PubMed

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