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Hyponatremia and long-term outcomes in chronic heart failure--an observational study from the Duke Databank for Cardiovascular Diseases.
J Card Fail. 2012 Jan; 18(1):74-81.JC

Abstract

BACKGROUND

Hyponatremia is a well known predictor of short-term outcomes in heart failure (HF); however, its impact on long-term survival in HF patients with systolic dysfunction is not well established.

METHODS AND RESULTS

Using the Duke Databank for Cardiovascular Diseases, we identified 1,045 patients with HF and systolic dysfunction undergoing cardiac catheterization from January 2000 through December 2008. The effect of hyponatremia as independent predictor of all-cause death and cardiovascular death/rehospitalization was examined using a multivariable Cox proportional regression model. Hyponatremia was present in 107/1,045 patients (10.2%). Hyponatremic patients were older, more likely to be anemic, with higher heart rate and levels of blood urea nitrogen, lower blood pressure, and more severe HF. Using an unadjusted analysis, hyponatremia was associated with higher risk of all-cause death (hazard ratio [HR] 1.89, 95% confidence interval [CI] 1.44-2.49; P < .0001) and of cardiovascular death/rehospitalization (HR 1.40, 95% CI 1.11-1.77; P = .005) at 4.5 years. When entered into a multivariable Cox model, hyponatremia remained significant for all-cause death (HR 1.42, 95% CI 1.07-1.88) and for cardiovascular death/rehospitalization (HR 1.45, 95% CI 1.14-1.86).

CONCLUSIONS

Hyponatremia is relatively common in HF patients with LV dysfunction and is independently associated with increased risk of all-cause mortality and cardiovascular mortality/rehospitalization.

Authors+Show Affiliations

Section of Cardiovascular Diseases, Department of Experimental and Applied Medicine, University of Brescia, Brescia, Italy. luca_bettari@yahoo.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22196845

Citation

Bettari, Luca, et al. "Hyponatremia and Long-term Outcomes in Chronic Heart Failure--an Observational Study From the Duke Databank for Cardiovascular Diseases." Journal of Cardiac Failure, vol. 18, no. 1, 2012, pp. 74-81.
Bettari L, Fiuzat M, Shaw LK, et al. Hyponatremia and long-term outcomes in chronic heart failure--an observational study from the Duke Databank for Cardiovascular Diseases. J Card Fail. 2012;18(1):74-81.
Bettari, L., Fiuzat, M., Shaw, L. K., Wojdyla, D. M., Metra, M., Felker, G. M., & O'Connor, C. M. (2012). Hyponatremia and long-term outcomes in chronic heart failure--an observational study from the Duke Databank for Cardiovascular Diseases. Journal of Cardiac Failure, 18(1), 74-81. https://doi.org/10.1016/j.cardfail.2011.09.005
Bettari L, et al. Hyponatremia and Long-term Outcomes in Chronic Heart Failure--an Observational Study From the Duke Databank for Cardiovascular Diseases. J Card Fail. 2012;18(1):74-81. PubMed PMID: 22196845.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hyponatremia and long-term outcomes in chronic heart failure--an observational study from the Duke Databank for Cardiovascular Diseases. AU - Bettari,Luca, AU - Fiuzat,Mona, AU - Shaw,Linda K, AU - Wojdyla,Daniel M, AU - Metra,Marco, AU - Felker,G Michael, AU - O'Connor,Christopher M, Y1 - 2011/10/19/ PY - 2011/06/11/received PY - 2011/09/01/revised PY - 2011/09/07/accepted PY - 2011/12/27/entrez PY - 2011/12/27/pubmed PY - 2012/5/4/medline SP - 74 EP - 81 JF - Journal of cardiac failure JO - J Card Fail VL - 18 IS - 1 N2 - BACKGROUND: Hyponatremia is a well known predictor of short-term outcomes in heart failure (HF); however, its impact on long-term survival in HF patients with systolic dysfunction is not well established. METHODS AND RESULTS: Using the Duke Databank for Cardiovascular Diseases, we identified 1,045 patients with HF and systolic dysfunction undergoing cardiac catheterization from January 2000 through December 2008. The effect of hyponatremia as independent predictor of all-cause death and cardiovascular death/rehospitalization was examined using a multivariable Cox proportional regression model. Hyponatremia was present in 107/1,045 patients (10.2%). Hyponatremic patients were older, more likely to be anemic, with higher heart rate and levels of blood urea nitrogen, lower blood pressure, and more severe HF. Using an unadjusted analysis, hyponatremia was associated with higher risk of all-cause death (hazard ratio [HR] 1.89, 95% confidence interval [CI] 1.44-2.49; P < .0001) and of cardiovascular death/rehospitalization (HR 1.40, 95% CI 1.11-1.77; P = .005) at 4.5 years. When entered into a multivariable Cox model, hyponatremia remained significant for all-cause death (HR 1.42, 95% CI 1.07-1.88) and for cardiovascular death/rehospitalization (HR 1.45, 95% CI 1.14-1.86). CONCLUSIONS: Hyponatremia is relatively common in HF patients with LV dysfunction and is independently associated with increased risk of all-cause mortality and cardiovascular mortality/rehospitalization. SN - 1532-8414 UR - https://www.unboundmedicine.com/medline/citation/22196845/Hyponatremia_and_long_term_outcomes_in_chronic_heart_failure__an_observational_study_from_the_Duke_Databank_for_Cardiovascular_Diseases_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1071-9164(11)01144-4 DB - PRIME DP - Unbound Medicine ER -