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  • The prognosis of heart failure patients: Does sodium level play a significant role?

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    Author(s)
    Abebe, Tamrat Befekadu
    Gebreyohannes, Eyob Alemayehu
    Tefera, Yonas Getaye
    Bhagavathula, Akshaya Srikanth
    Erku, Daniel Asfaw
    Belachew, Sewunet Admasu
    Gebresillassie, Begashaw Melaku
    Abegaz, Tadesse Melaku
    Griffith University Author(s)
    Erku, Daniel
    Year published
    2018
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    Abstract
    INTRODUCTION: Heart failure (HF), a major cardiovascular disorder, remains a grievous clinical condition regardless of advances in medical care. Hyponatremia is classified as a serum sodium concentration of <135 mEq/L, and the prevalence, clinical impact and prognostic factor of hyponatremia in heart failure patients varies widely. The current study was conducted with the aim of assessing the prevalence of hyponatremia in patients hospitalized with a diagnosis of HF and comparing baseline clinical characteristic of HF patients based on their sodium status. Survival difference between patients with hyponatremia and normonatremia ...
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    INTRODUCTION: Heart failure (HF), a major cardiovascular disorder, remains a grievous clinical condition regardless of advances in medical care. Hyponatremia is classified as a serum sodium concentration of <135 mEq/L, and the prevalence, clinical impact and prognostic factor of hyponatremia in heart failure patients varies widely. The current study was conducted with the aim of assessing the prevalence of hyponatremia in patients hospitalized with a diagnosis of HF and comparing baseline clinical characteristic of HF patients based on their sodium status. Survival difference between patients with hyponatremia and normonatremia was also assessed and the clinical prognostic indicators of overall mortality in HF patients were evaluated. METHOD: A retrospective cohort study was conducted to assess medical records of heart failure patients who were admitted to Gondar University Referral Hospital. Patients were categorized based on their sodium level status at their first admission to the internal medicine department. Each patient was assigned to either of the following groups: hyponatremia if sodium < 135 mmol/L, or normonatremia if sodium ≥ 135 mmol/L. RESULT: Among 388 participants, the prevalence of hyponatremia in the study cohorts was 51.03%. Kaplan-Meier survival curves showed that there was a significant difference in survival status of HF patients among the two cohorts (Log-Rank test, P <0.0001). Hence, patients with normal sodium levels had a higher chance of survival over hyponatremic patients. Multivariate Cox regression has revealed a statistically significant association of mortality with the following variables: advanced age (AHR = 1.035 (1.012-1.058), P = 0.003), hyponatremia (AHR = 4.003 (1.778-9.009), P = 0.001), higher creatinine level (AHR = 1.929 (1.523-2.443), P = <0.0001) and, prescription of angiotensin-converting enzyme inhibitors (AHR = 0.410 (0.199-0.842), P = 0.015) and spironolactone (AHR = 0.511 (0.275-0.949), P = 0.033. CONCLUSION: In conclusion, hyponatremia is one of the crucial factors in the clinical prognosis of heart failure patients. However, as other prognostic factors (i.e. medication, creatine level, and age) also played vital roles in overall survival, well-controlled clinical trials (complete with medication dosing, laboratory outputs and long-term prospective follow up) are required to further study the impact of hyponatremia in HF patient's prognosis in low income nations.
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    Journal Title
    PLoS One
    Volume
    13
    Issue
    11
    DOI
    https://doi.org/10.1371/journal.pone.0207242
    Copyright Statement
    © 2018 Abebe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
    Subject
    Clinical sciences
    Science & Technology
    Multidisciplinary Sciences
    Science & Technology - Other Topics
    PRESERVED SYSTOLIC FUNCTION
    SALINE SOLUTION INFUSION
    Publication URI
    http://hdl.handle.net/10072/397544
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    • Journal articles

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