Huang Haozhang, Mai Ziling, Chen Liling, Li Qiang, Chen Shiqun, Bao Kunming, Tang Ronghui, Wei Wen, Yu Yaren, Huang Zhidong, Lai Wenguang, Wang Bo, Tan Ning, Chen Jiyan, Liu Jin, Liu Yong
Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China.
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, People's Republic of China.
Risk Manag Healthc Policy. 2021 Jul 27;14:3137-3145. doi: 10.2147/RMHP.S306125. eCollection 2021.
Hypochloremia is a predictor for short-term mortality in patients with cardiovascular disease, but its association with coronary artery disease (CAD) is still unclear. We aimed to assess the impact of hypochloremia on all-cause mortality (short-and long-term) among patients with CAD.
Based on the registry at Guangdong Provincial People's Hospital in China, we analyzed data of 49,025 hospitalized patients who underwent coronary angiography (CAG) and were diagnosed with CAD from January 2007 to December 2018. To assess the association between hypochloremia and the study endpoints, a logistic-regression model (for 30-day all-cause mortality) and a Cox regression model (for long-term all-cause mortality) were fitted.
Overall, 4.4% of the study population showed hypochloremia (<98 mmol/L). During a median follow-up of 5.2 (3.1-7.8) years, a total of 6486 (13.2%) patients died. Patients with hypochloremia were generally older and at risk for diabetes, cardiorenal dysfunction, and morbidity than those without hypochloremia. After adjustment for confounders, hypochloremia remained a significant predictor of mortality risk (30-day all-cause death: adjusted odds ratio [aOR], 1.99; 95% confidence interval, 1.08-3.18; P=0.017 and long-term all-cause death: adjusted hazard ratio [aHR], 1.32; 95% confidence interval, 1.19-1.47; P<0.001).
Hypochloremia is mildly common in patients with CAD and is associated with increased short-and long-term mortality. Meanwhile, it is necessary to further investigate effective and preventive measures and the potential mechanisms of hypochloremia in patients with CAD.
低氯血症是心血管疾病患者短期死亡率的一个预测指标，但其与冠状动脉疾病（CAD）的关联仍不明确。我们旨在评估低氯血症对CAD患者全因死亡率（短期和长期）的影响。
基于中国广东省人民医院的登记数据，我们分析了2007年1月至2018年12月期间49025例接受冠状动脉造影（CAG）并被诊断为CAD的住院患者的数据。为评估低氯血症与研究终点之间的关联，采用了逻辑回归模型（用于30天全因死亡率）和Cox回归模型（用于长期全因死亡率）。
总体而言，4.4%的研究人群存在低氯血症（<98 mmol/L）。在中位随访5.2（3.1 - 7.8）年期间，共有6486例（13.2%）患者死亡。低氯血症患者通常比无低氯血症患者年龄更大，且有患糖尿病、心肾功能不全和发病的风险。在对混杂因素进行调整后，低氯血症仍然是死亡风险的显著预测指标（30天全因死亡：调整后的优势比[aOR]，1.99；95%置信区间，1.08 - 3.18；P = 0.017；长期全因死亡：调整后的风险比[aHR]，1.32；95%置信区间，1.19 - 1.47；P < 0.001）。
低氯血症在CAD患者中较为常见，且与短期和长期死亡率增加相关。同时，有必要进一步研究CAD患者低氯血症的有效预防措施及潜在机制。
