Seigato Hospital, Kawachi 897, Nishi-ku, Kumamoto, 861-5347, Japan.
Ueki Hospital, Kumamoto, Japan.
Heart Vessels. 2021 Jan;36(1):85-91. doi: 10.1007/s00380-020-01673-2. Epub 2020 Jul 27.
We have reported that high sodium excretion ≥ 4.0 g/day, assessed by repeated measurements of spot urine, is associated with composite cardiovascular (CV) events of heart failure (HF) hospitalization, acute coronary syndrome, cerebrovascular events, and documented CV deaths in Japanese high-risk patients with either stable and compensated congestive HF, high brain natriuretic peptide, coronary artery disease, cerebrovascular disease, chronic kidney disease, or atrial fibrillation. A total of 520 patients were enrolled. During the median follow-up period of 5.2 years, 105 (20%) experienced composite CV events, which were predominantly driven by 60 (12%) HF hospitalizations. The aim of the present study was to elucidate which subgroups of patients with high sodium excretion were associated with HF hospitalization. We divided the enrolled patients into three groups according to the amount of sodium excretion (< 3.0 g/day, 3.0-3.99 g/day (reference), and ≥ 4.0 g/day) based on a median of 14 measurements during follow-up. We assessed the hazard ratio for HF hospitalization according to age, bodyweight, and gender, using the Cox hazard model. In the total population, high sodium excretion ≥ 4.0 g/day was associated with HF hospitalization [hazard ratio (HR) 1.75, confidence interval (CI) 1.05-2.83] after adjustment for gender, age, and bodyweight, but was not associated with other CV events. In older patients (≥ 75 years old), high sodium excretion ≥ 4.0 g/day was associated with HF hospitalization after adjustment for gender and bodyweight (HR 3.25, CI 1.55-6.55), which was not observed in younger (< 75 years old) patients. In patients with lower bodyweight (< 60 kg), high sodium excretion ≥ 4.0 g/day was associated with HF hospitalization after adjustment for age and gender (HR 3.05, CI 1.34-6.61), which was not observed in heavier (≥ 60 kg) patients. High sodium excretion is associated with HF hospitalization in patients with older age and lower bodyweight in Japanese high-risk patients.
我们曾报道，通过多次检测尿样得出的高钠排泄量（≥4.0g/天）与日本高危患者的复合心血管（CV）事件（心力衰竭[HF]住院、急性冠状动脉综合征、脑血管事件和有记录的 CV 死亡）相关，这些高危患者包括稳定和代偿性充血性 HF、高脑钠肽、冠状动脉疾病、脑血管疾病、慢性肾脏病或心房颤动患者。共有 520 名患者入组。在中位随访 5.2 年期间，105 名（20%）患者发生复合 CV 事件，其中主要由 60 名（12%）HF 住院患者驱动。本研究旨在阐明高钠排泄患者的哪些亚组与 HF 住院相关。我们根据随访期间 14 次测量的中位数，将入组患者分为三组：<3.0g/天、3.0-3.99g/天（参考）和≥4.0g/天。我们使用 Cox 风险模型根据年龄、体重和性别评估 HF 住院的风险比。在总人群中，在校正性别、年龄和体重后，高钠排泄量（≥4.0g/天）与 HF 住院相关（风险比[HR]1.75，95%置信区间[CI]1.05-2.83），但与其他 CV 事件无关。在年龄较大的患者（≥75 岁）中，在校正性别和体重后，高钠排泄量（≥4.0g/天）与 HF 住院相关（HR 3.25，95%CI 1.55-6.55），但在年龄较小的患者（<75 岁）中则无此关联。在体重较轻的患者（<60kg）中，在校正年龄和性别后，高钠排泄量（≥4.0g/天）与 HF 住院相关（HR 3.05，95%CI 1.34-6.61），但在体重较重的患者（≥60kg）中则无此关联。高钠排泄与日本高危患者中年龄较大和体重较轻的患者的 HF 住院相关。
