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W2809683266 abstract "The prognostic effect of the direction of change in sodium (Na) level from admission to subsequent check in patients with acute heart failure (HF) has not been previously explored.The ESCAPE trial data was utilized to study whether the rise of 1st follow-up Na (at day 3) relative to admission (among patients with admission hyponatremia) is associated with favorable outcomes. The study endpoints were all-cause rehospitalization and a composite of death, rehospitalization and cardiac transplant, both up to 6-month after discharge.Patients with rise of 1st follow-up Na (n = 43) had an average admission Na of 130.1 meq/L which increased to 134 meq/L at day 3 (P < 0.001), while patients without rise of 1st follow up Na (n = 46) had an admission Na of 131 meq/L which decreased to 128.9 meq/L at day 3 (P < 0.001). There was an inverse association between the magnitude of change in Na level from admission to day 3 and the magnitude of change in blood urea nitrogen (BUN, r = -0.304, P = 0.004), creatinine (r = -0.401, P < 0.001) and weight (r = -0.279, P = 0.011) during the same time frame. Among those 89 cases, 56 (63%) were rehospitalized and 70 (79%) experienced the composite endpoint. Patients without rise in 1st follow-up Na had higher frequency of rehospitalization (76.1% vs. 48.8%, univariate Odds ratio (OR) 1.778, 95% CI 1.174-2.693, P = 0.009) and composite endpoint (89.1% vs. 67.4%, univariate OR 1.779, 95% CI 1.208-2.619, P = 0.017), compared with those with Na rise. Cox regression analysis showed that rise in 1st follow-up Na was independently associated with reduced rehospitalization (Hazard ratio (HR) 0.429, 95% CI 0.191-0.960, P = 0.04) and the composite endpoint (HR 0.430, 95% CI 0.201-0.920, P = 0.03) after covariate adjustment.Rise of first follow-up Na in patients with HF decompensation and hyponatremia on admission is associated with favorable intermediate-term outcomes." @default.
W2809683266 created "2018-06-29" @default.
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W2809683266 date "2018-10-01" @default.
W2809683266 modified "2023-09-24" @default.
W2809683266 title "Rise of first follow-up sodium in patients hospitalized with acute heart failure is associated with better outcomes" @default.
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W2809683266 doi "https://doi.org/10.1016/j.ijcard.2018.06.071" @default.
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