Prognostic Value of Hyponatremia in Elderly Patients with Acute Coronary Syndrome

Abstract

Objectives: to analyse in-hospital outcomes and prognostic implications of reduced sodium serum level (S-Na) in patients with acute coronary syndrome including ST elevation myocardial infarction (STEMI) and non ST elevation myocardial infarction (non-STEMI). Design: A cross sectional study was conducted on elderly patients. Participants: One hundred patients aged > 60 years, both males and females. Setting: Participants were recruited from cardiology intensive care unit in Ain Shams University hospitals. Measurements: All patients had a sodium level determined at time of admission and after 48 hours, serial ECG and cardiac enzymes (creatine phosphokinase (CPK) and CPK-MB fraction) levels. Results: Of 100 patients, 52 patients were admitted with STEMI and 48 with NSTEMI; 73 were hyponatremic (S-Na <135 mEq/L) and 27 were normonatremic (S>or=135 mEq/L). Patients who had hyponatremia were more likely to die or have recurrent myocardial infarction in the next 30 days (p <0.05). Hyponatremia, hypotension on admission, left ventricular ejection fraction (EF), mean level of cardiac enzymes were significantly associated with adverse outcome. On multivariate analysis, hyponatremia was a strong predictor of adverse outcome (odds ratio 2.4, 95% confidence interval). In conclusion, hyponatremia is associated with 30-days adverse outcome in patients presenting with acute coronary syndrome.

Electrolyte Imbalance Among Patients With and With No ST-Elevation Myocardial Infarction

“…5 Electrolyte imbalances have a high impact on mortality in patients with ACS. 6,7 Hyponatremia, hypokalemia, and hypomagnesemia were observed in patients with ACS. [8][9][10] These low-serum electrolytes have prognostic value in predicting mortality in patients with ACS.…”

“…Treatment modalities may also play a contributing role, for example, the administration of diuretics 5. Electrolyte imbalances have a high impact on mortality in patients with ACS 6,7. Hyponatremia, hypokalemia, and hypomagnesemia were observed in patients with ACS 8–10.…”