Document Detail


Relationship of serum sodium concentration to mortality in a wide spectrum of heart failure patients with preserved and with reduced ejection fraction: an individual patient data meta-analysis{dagger}: Meta-Analysis Global Group in Chronic heart failure (MAGGIC).
MedLine Citation:
PMID:  22782968     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIMS: Hyponatraemia has been associated with reduced survival in patients with heart failure and reduced ejection fraction (HF-REF). The relationship between serum sodium and outcome is unclear in heart failure with preserved (≥50%) ejection fraction (HF-PEF). Therefore, we used a large individual patient data meta-analysis to study the risk of death associated with hyponatraemia in HF-REF and in HF-PEF. METHODS AND RESULTS: This analysis included 14 766 patients from 22 studies that recruited patients without ejection fraction inclusion criterion at baseline and reported death from any cause. Cox proportional analysis was undertaken for hyponatraemia (sodium <135 mmol/L), adjusted for variables of clinical relevance, and stratified by study. The endpoint was death from any cause at 3 years. Patients with hyponatraemia (n = 1618) and patients with normal serum sodium had similar characteristics as regards to age, gender, and ischaemic aetiology. However, patients with hyponatraemia had higher New York Heart Association class and lower blood pressure. At follow-up, there were 335 deaths among 1618 patients with hyponatraemia (21%) and 2128 deaths among 13 148 patients with normal serum sodium (16%). The risk of death appeared to increase linearly with serum sodium levels <140 mmol/L. Hyponatraemia was identified in 1199 HF-REF patients (11%) and 419 HF-PEF patients (11%). Hyponatraemia was independently predictive of death in both HF-REF [adjusted hazard ratio (HR) 1.69, 95% confidence interval (CI) 1.50-1.91] and HF-PEF (adjusted HR 1.40, 95% CI 1.10-1.79, P for interaction 0.20). CONCLUSION: Hyponatraemia is a powerful determinant of mortality in patients with HF regardless of ejection fraction. Further work is needed to determine if correction of hyponatraemia translates into clinical benefit.
Authors:
Dan Rusinaru; Christophe Tribouilloy; Colin Berry; A Mark Richards; Nikki Earle; Katrina K Poppe; Marco Guazzi; Stella M Macin; Michel Komajda; Robert N Doughty;
Related Documents :
22152098 - A short-chain methotrexate polyglutamate as outcome parameter in rheumatoid arthritis p...
22905988 - Higher serum levels of soluble intracellular cell adhesion molecule-1 and soluble vascu...
22076548 - Spinal subtraction mri for diagnosis of epidural leakage in sih.
22015178 - Elevated osteoprotegerin is associated with inflammation, malnutrition and new onset ca...
24983298 - Copd-related bronchiectasis; independent impact on disease course and outcomes.
21926658 - Hepatoadrenal syndrome in pediatric patients with end-stage liver disease.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-9
Journal Detail:
Title:  European journal of heart failure     Volume:  -     ISSN:  1879-0844     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Cardiovascular Diseases, Amiens University Hospital, 80054 Amiens Cedex 1, France.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Induction of Bcl-3 by acute binge alcohol results in toll-like receptor 4/LPS tolerance.
Next Document:  Heart failure in severe aortic valve stenosis: prognostic impact of left ventricular ejection fracti...