Plasma osmolality predicts clinical outcome in patients with acute coronary syndrome undergoing percutaneous coronary intervention

Abstract

Using the 4th quartile of plasma osmolality at admission as a natural cut-off point, osmolality in Q4, as compared to Q1-3, was significantly predictive of short term but not long-term outcome in ACS patients undergoing coronary stenting. Our data suggest osmolality to be an independent, feasible, and cost-effective tool for rapid risk stratification in ACS patients.

Calculated Serum Osmolality, Acute Kidney Injury, and Relationship to Mortality after Percutaneous Coronary Intervention

“…Bhalla et al [14] found an association between increased osmolality and short-term mortality in 167 consecutive patients with acute stroke. Recently, two studies showed an association of increased sOsmo and short- as well as long-term mortality in patients after ACS [3, 15]. Rohla et al [3] analyzed the data of 985 consecutive patients with non-STEMI and STEMI in whom sOsmo was calculated from laboratory results obtained within 8 h of admission.…”

“…Recently, two studies showed an association of increased sOsmo and short- as well as long-term mortality in patients after ACS [3, 15]. Rohla et al [3] analyzed the data of 985 consecutive patients with non-STEMI and STEMI in whom sOsmo was calculated from laboratory results obtained within 8 h of admission. Patients in the highest sOsmo quartile had the highest risk of 30-day mortality compared to patients in the other quartiles combined.…”

“…sOsmo was calculated from laboratory results obtained before PCI using the following equation: sOsmo = (1.86 × Na [mmol/L]) + (glucose [mg/dL] / 18) + (BUN [mg/dL] / 2.8) + 9 [5], as described in an earlier study in patients with CAD [3]. The normal reference range of sOsmo is 275–295 mOsm/kg (mmol/kg).…”

“…Hydration status prior to and after PCI has been shown to be independently associated with development of AKI [2]. Serum osmolality (sOsmo) has been shown to be associated with a higher risk of short-term mortality after PCI in patients with acute coronary syndrome (ACS) and predicts the all-cause mortality in patients hospitalized for heart failure [3, 4]. …”

Association between Serum Osmolarity and Coronary Artery Stenosis Grade

“…Computable osmolarity, including these components, is an important indicator for CAD and mortality [17] Hyperosmolar nutrition, termed sodium, glucose and protein-rich nutrition, is the basis for atherosclerosis, leading to metabolic activity resulting in increased heat, especially coronary artery deterioration in the body6. It is important to remove the person's hyperosmolar from the diet or to define the limits, to protect from the CAD, at least to delay disease development.…”