Sarastri Yuke, Zebua Juang Idaman, Lubis Puja Nastia, Zahra Fathi, Lubis Anggia Chairuddin
Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
Department of Cardiology and Vascular Medicine, RSUP Haji Adam Malik Medan, Medan, Indonesia.
ESC Heart Fail. 2023 Oct;10(5):2966-2972. doi: 10.1002/ehf2.14472. Epub 2023 Jul 30.
Heart failure remained consistent as one of the biggest cardiovascular problems in Indonesia. Hyponatraemia is a common electrolyte disorder among patients presented with heart failure; however, the prognostic value for worsening heart failure has not been well defined.
We studied 134 patients admitted with acute heart failure and investigated the relationship between admission serum sodium and the composite clinical outcomes of all-cause mortality and hospitalization ambispectively with a follow-up duration of 6 months. We also try to look for low sodium-level impacts in several conditions. Among 134 patients, 84 patients presented with low sodium during admission, defined as a serum sodium level of <135 mEq/L, and it was associated with higher composite clinical outcome risk [odds ratio (OR), 5.9; 95% confidence interval (CI), 2.8-12.0; P < 0.001]. Moreover, hyponatraemia impacts on composite endpoints were driven by both parameters; it was independently associated with mortality (OR, 3.1; 95% CI, 1.4-6.8; P = 0.003) and rehospitalization (OR, 5.3; 95% CI, 2.4-11.7; P < 0.001). This result remained consistent in most subgroups.
On-admission hyponatraemia is a predictor for 6 month mortality and rehospitalization. Further work is needed to determine if correction of hyponatraemia translates into clinical benefit.
心力衰竭一直是印度尼西亚最严重的心血管问题之一。低钠血症是心力衰竭患者中常见的电解质紊乱；然而，其对心力衰竭恶化的预后价值尚未明确界定。
我们研究了134例急性心力衰竭入院患者，调查入院时血清钠水平与全因死亡率和再次住院的综合临床结局之间的关系，并进行了为期6个月的随访。我们还试图在几种情况下寻找低钠水平的影响。在134例患者中，84例入院时出现低钠血症，定义为血清钠水平<135 mEq/L，这与更高的综合临床结局风险相关[比值比（OR），5.9；95%置信区间（CI），2.8 - 12.0；P < 0.001]。此外，低钠血症对综合终点的影响由两个参数驱动；它与死亡率（OR，3.1；95% CI，1.4 - 6.8；P = 0.003）和再次住院（OR，5.3；95% CI，2.4 - 11.7；P < 0.001）独立相关。这一结果在大多数亚组中保持一致。
入院时低钠血症是6个月死亡率和再次住院的预测指标。需要进一步研究以确定纠正低钠血症是否能转化为临床获益。
