PMID- 21184540
OWN - NLM
STAT- MEDLINE
DCOM- 20110408
LR  - 20221207
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Print)
IS  - 0160-9289 (Linking)
VI  - 33
IP  - 12
DP  - 2010 Dec
TI  - Low serum sodium as a poor prognostic indicator for mortality in congestive heart 
      failure patients.
PG  - E13-7
LID - 10.1002/clc.20560 [doi]
AB  - 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 beta-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 (c) 2010 Wiley Periodicals, 
      Inc.
CI  - Copyright (c) 2010 Wiley Periodicals, Inc.
FAU - DeWolfe, Andrew
AU  - DeWolfe A
AD  - University of Miami, Florida, USA.
FAU - Lopez, Barbara
AU  - Lopez B
FAU - Arcement, Lee M
AU  - Arcement LM
FAU - Hebert, Kathy
AU  - Hebert K
LA  - eng
PT  - Journal Article
DEP - 20101122
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Biomarkers)
RN  - 9NEZ333N27 (Sodium)
SB  - IM
MH  - Adrenergic beta-Antagonists/therapeutic use
MH  - Adult
MH  - Black or African American/statistics & numerical data
MH  - Aged
MH  - Angiotensin-Converting Enzyme Inhibitors/therapeutic use
MH  - Biomarkers/blood
MH  - Chi-Square Distribution
MH  - Cross-Sectional Studies
MH  - Drug Therapy, Combination
MH  - Female
MH  - Heart Failure/*blood/drug therapy/ethnology/*mortality
MH  - Humans
MH  - Hyponatremia/*blood/ethnology/*mortality
MH  - Kaplan-Meier Estimate
MH  - Louisiana/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - Proportional Hazards Models
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Sodium/*blood
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC6653197
EDAT- 2010/12/25 06:00
MHDA- 2011/04/09 06:00
PMCR- 2010/11/22
CRDT- 2010/12/25 06:00
PHST- 2008/08/14 00:00 [received]
PHST- 2008/11/29 00:00 [revised]
PHST- 2010/12/25 06:00 [entrez]
PHST- 2010/12/25 06:00 [pubmed]
PHST- 2011/04/09 06:00 [medline]
PHST- 2010/11/22 00:00 [pmc-release]
AID - CLC20560 [pii]
AID - 10.1002/clc.20560 [doi]
PST - ppublish
SO  - Clin Cardiol. 2010 Dec;33(12):E13-7. doi: 10.1002/clc.20560. Epub 2010 Nov 22.