Effect of Hyponatremia (&lt;135 mEq/L) on Outcome in Patients With Non–ST-Elevation Acute Coronary Syndrome

Singla, Ish; Zahid, Maliha; Good, Chester B.; Macioce, Alanna; Sonel, Ali F.

doi:10.1016/j.amjcard.2007.03.039

Cited by 40 publications

(49 citation statements)

References 8 publications

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“…Further, the risk of mortality increased with the severity of hyponatremia. Similar observations have been reported in other studies (7,9). Goldberg and colleagues observed that hyponatremia on admission or developing during the first 72 hours of hospitalization in STEMI was independently associated with increased 30-day mortality risk as well a higher incidence of post-discharge readmission for heart failure and death in long-term followup (7,8).…”

Section: Discussionsupporting

confidence: 76%

“…Goldberg and colleagues observed that hyponatremia on admission or developing during the first 72 hours of hospitalization in STEMI was independently associated with increased 30-day mortality risk as well a higher incidence of post-discharge readmission for heart failure and death in long-term followup (7,8). Then Singla et al reported that hyponatremia was associated with adverse 30-day outcomes in patients admitted with non-ST-elevation myocardial infarction and degree of hyponatremia correlated with an increasing number of adverse events (9). Later, Klopotowski et al documented a relationship between hyponatremia in STEMI patients treated with primary angioplasty and in-hospital mortality or the composite of death and heart failure (12).…”

Section: Discussionmentioning

confidence: 99%

“…Although we were unable to determine whether patients were admitted with preexisting asymptomatic hyponatremia, we observed no difference in systolic blood pressure, prior myocardial infarction and Killip class on admission in STEMI patients. On the other hand, Singla et al and Klopotowski et al reported patients in acute myocardial infarction developed hyponatremia at admission or within the first 48 after admission (9,12). Therefore, hyponatremia in acute myocardial infarction may belong to acute hyponatremia, which develops in less than 48 hours and is generally hospital acquired (20).…”

Section: Discussionmentioning

confidence: 99%

“…The fall in sodium concentrations in these patients is related to activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system, and neurohormone-mediated, nonosmotic release of vasopressin (AVP). Recently, some studies have shown that hyponatremia is linked to poor outcomes in patients with ST-elevation myocardial infarction (STEMI) and non-ST elevation acute coronary syndrome and the risk of mortality increased with the severity of hyponatremia (7)(8)(9). However, the influence of hyponatremia on the prevalence and prognosis in Chinese patients with STEMI has been unclarified.…”

Section: Introductionmentioning

confidence: 95%

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Relationship between Hyponatremia and In-hospital Outcomes in Chinese Patients with ST-Elevation Myocardial Infarction

Tang

Hua

2011

Intern. Med.

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Objective This study was investigated to determine the relationship between hyponatremia and in-hospital outcomes in Chinese patients with ST-elevation myocardial infarction. Methods Plasma sodium concentration was obtained in all patients on admission and analyzed as hyponatremia versus normalnatremia. The relationships between hyponatremia and in-hospital mortality as well as heart failure were assessed. Results Of 1,620 patients, 212 (13.1%) patients had hyponatremia on presentation (sodium <135 mmol/L). Patients with hyponatremia had higher rates of in-hospital mortality (13.7% vs. 7.3%, p=0.002) and heart failure (30.2% vs. 18%, p<0.001). Patients with a sodium level of <130 mmol/L had an adverse event rate of 22.9% versus 11.0% in patients with a sodium level of 130 to 135 mmol/L (p=0.034). In multivariate logistic regression, hyponatremia was independently correlated with in-hospital mortality (OR: 1.77, 95% CI: 1.02-3.06, p=0.042) and heart failure (OR: 1.61, 95% CI: 1.06-2.43, p=0.025). Conclusion Hyponatremia is independently associated with in-hospital adverse outcomes in Chinese patients with acute ST-elevation myocardial infarction, and the risk of in-hospital mortality was increased with the severity of hyponatremia.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

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Relationship between Hyponatremia and In-hospital Outcomes in Chinese Patients with ST-Elevation Myocardial Infarction

Tang

Hua

2011

Intern. Med.

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“…Hyponatremia was a significant risk factor in a 30-day observation (Goldberg et al, 2004). Similarly, Singla et al (2007) noticed that in their research, performed with a group of 1,478 patients with NSTEMI, 341 patients had had hyponatremia, which is a risk factor of 30-day mortality. Moreover, a paper published by Lazzeri et al (2012) showed that in a group of 1,231 patients with STEMI, 23.2% (286 patients) had a serum sodium concentration below 135 mEq/l.…”

Section: Cox Regression Model In the Case Of Violation Of The Assumptmentioning

confidence: 99%

Limitations of Cox Proportional Hazards Analysis in Mortality Prediction of Patients with Acute Coronary Syndrome

Babińska

Chudek

Chełmecka

et al. 2015

Studies in Logic, Grammar and Rhetoric

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Abstract. The aim of this study was to evaluate the possibility of incorrect assessment of mortality risk factors in a group of patients affected by acute coronary syndrome, due to the lack of hazard proportionality in the Cox regression model. One hundred and fifty consecutive patients with acute coronary syndrome (ACS) and no age limit were enrolled. Univariable and multivariable Cox proportional hazard analyses were performed. The proportional hazard assumptions were verified using Schoenfeld residuals, χ2 test and rank correlation coefficient t between residuals and time. In the total group of 150 patients, 33 (22.0%) deaths from any cause were registered in the follow-up time period of 64 months. The non-survivors were significantly older and had increased prevalence of diabetes and erythrocyturia, longer history of coronary artery disease, higher concentrations of serum creatinine, cystatin C, uric acid, glucose, C-reactive protein (CRP), homocysteine and B-type natriuretic peptide (NT-proBNP), and lower concentrations of serum sodium. No significant differences in echocardiography parameters were observed between groups. The following factors were risk of death factors and fulfilled the proportional hazard assumption in the univariable model: smoking, occurrence of diabetes and anaemia, duration of coronary artery disease, and abnormal serum concentrations of uric acid, sodium, homocysteine, cystatin C and NT-proBNP, while in the multivariable model, the risk of death factors were: smoking and elevated concentrations of homocysteine and NT-proBNP. The study has demonstrated that violation of the proportional hazard assumption in the Cox regression model may lead to creating a false model that does not include only time-independent predictive factors.

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Impact of pre‐procedural hyponatremia on clinical outcomes after transcatheter aortic valve replacement: A propensity‐matched analysis

Kagase

Yamamoto

Shimura

et al. 2018

Cathet Cardio Intervent

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Effect of Hyponatremia (<135 mEq/L) on Outcome in Patients With Non–ST-Elevation Acute Coronary Syndrome

Cited by 40 publications

References 8 publications

Relationship between Hyponatremia and In-hospital Outcomes in Chinese Patients with ST-Elevation Myocardial Infarction

Relationship between Hyponatremia and In-hospital Outcomes in Chinese Patients with ST-Elevation Myocardial Infarction

Limitations of Cox Proportional Hazards Analysis in Mortality Prediction of Patients with Acute Coronary Syndrome

Impact of pre‐procedural hyponatremia on clinical outcomes after transcatheter aortic valve replacement: A propensity‐matched analysis

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