PMID- 32765046
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220416
IS  - 1178-7074 (Print)
IS  - 1178-7074 (Electronic)
IS  - 1178-7074 (Linking)
VI  - 13
DP  - 2020
TI  - Predictors of Mortality in Patients with Chronic Heart Failure: Is Hyponatremia a 
      Useful Clinical Biomarker?
PG  - 407-417
LID - 10.2147/IJGM.S260256 [doi]
AB  - BACKGROUND: Chronic heart failure (CHF) is a global health burden. Despite 
      advances in treatment, there remain well-recognised morbidity and mortality. Risk 
      stratification requires the identification and validation of biomarkers, old and 
      new. Hyponatremia has re-emerged as a prognostic marker in CHF patients. METHODS: 
      This is a retrospective cohort study on 241 CHF patients recruited from King Fahd 
      Hospital of the University, Al-Khobar, Saudi Arabia (January 2005-December 2016). 
      Their serum sodium and biochemical parameters were measured at baseline, along 
      with 2-D echocardiographic assessments of left ventricular mass and ejection 
      fraction. The primary endpoint was the association between hyponatremia and 
      all-cause mortality (ACM) after a follow-up period of 24 months. RESULTS: Mean 
      age of patients was 60.61 +/- 12.63 (SD) years; 65.1% were males, and type 2 
      diabetes mellitus (DM) was present in 71%. Baseline serum sodium was 138.00 (136, 
      140) (median and interquartile range). Hyponatremia (<135 meq/L) was present in 
      14.1%. After follow-up, 46 deaths had occurred. Multivariate Cox-proportional 
      hazard model showed that type 2 DM, New York Heart Association (NYHA) class 
      (III-IV vs I-II), age, and left ventricular mass index (LVMI) were significant 
      and independent predictors of ACM, with HR 3.03 (95% CI; 1.13, 8.16) (P=0.028), 
      HR 2.31 (95% CI; 1.11, 4.82) (P=0.026), HR 1.06 (95% CI; 1.03, 1.09) (P<0.001), 
      and HR 1.01 (95% CI; 1.00, 1.02) (P=0.039), respectively. Estimated glomerular 
      filtration rate (eGFR) was not a significant predictor. Kaplan-Meier survival 
      analysis was used for the analysis of NYHA class and hyponatremia interactions 
      and showed that hyponatremia had an association with poorer survival in patients 
      with NYHA class III-IV rather than I-II (Log-rank test, P= 0.0009). CONCLUSION: 
      Hyponatremia was a feature in CHF patients, and ACM was predicted by type 2 DM, 
      NYHA class, age, and LVMI. Hyponatremia impact on survival was in patients with 
      more advanced disease.
CI  - (c) 2020 Alem.
FAU - Alem, Manal M
AU  - Alem MM
AUID- ORCID: 0000-0001-8447-792X
AD  - Department of Pharmacology, College of Clinical Pharmacy, Imam Abdulrahman Bin 
      Faisal University, Dammam, Saudi Arabia.
LA  - eng
PT  - Journal Article
DEP - 20200720
PL  - New Zealand
TA  - Int J Gen Med
JT  - International journal of general medicine
JID - 101515487
PMC - PMC7381090
OTO - NOTNLM
OT  - Saudi Arabia
OT  - all-cause mortality
OT  - ejection fraction
OT  - electrolyte disturbance
OT  - heart failure
OT  - hyponatremia
OT  - left ventricular mass index
COIS- The author declares no conflict of interest.
EDAT- 2020/08/09 06:00
MHDA- 2020/08/09 06:01
PMCR- 2020/07/20
CRDT- 2020/08/09 06:00
PHST- 2020/04/28 00:00 [received]
PHST- 2020/06/18 00:00 [accepted]
PHST- 2020/08/09 06:00 [entrez]
PHST- 2020/08/09 06:00 [pubmed]
PHST- 2020/08/09 06:01 [medline]
PHST- 2020/07/20 00:00 [pmc-release]
AID - 260256 [pii]
AID - 10.2147/IJGM.S260256 [doi]
PST - epublish
SO  - Int J Gen Med. 2020 Jul 20;13:407-417. doi: 10.2147/IJGM.S260256. eCollection 
      2020.