Prevalence and prognostic significance of hyponatraemia in outpatients with chronic heart failure

TY - JOUR

T1 - Prevalence and prognostic significance of hyponatraemia in outpatients with chronic heart failure

AU - Balling, Louise

AU - Schou, Morten

AU - Videbæk, Lars

AU - Hildebrandt, Per

AU - Wiggers, Henrik

AU - Gustafsson, Finn

AU - Danish Heart Failure Clinics Network

PY - 2011/9

Y1 - 2011/9

N2 - Aim Hyponatraemia has been reported to be a potent predictor of poor outcome in patients hospitalized for heart failure (HF). The Aim of the study was to determine the prevalence and prognostic significance of hyponatraemia in a large cohort of HF outpatients followed in clinics participating in the Danish Heart Failure Clinics Network. Methods and resultsThe study population consisted of consecutive patients referred for HF management in 18 Danish heart failure clinics. Overall, 2863 patients (83) had a normal plasma sodium (p-sodium) level and 602 patients (17) had hyponatraemia with a p-sodium level <136 mmol/L. Outcome data were obtained from a validated, national registry. Patients were elderly with a mean age of 68 years. The mean P[Na] was 139.6 ± 2.4 mmol/L among patients with normonatraemia and 132.4 ± 3.2 mmol/L among patients with hyponatraemia. In multivariate Cox Proportional Hazard Models adjusted for confounders (age, gender, hospitalization within the last 90 days, loop diuretics, creatinine level, systolic blood pressure, New York Heart Association class IIIIV, left ventricular ejection fraction <0.46, ischaemic heart disease and diabetes) hyponatraemic patients had increased risk of hospitalization or death [hazard ratio (HR) 1.2 (95 confidence interval (CI) 1.01.4, P 0.011)]. Hyponatraemia was also an independent predictor of all-cause mortality [HR 1.5 (95 CI 1.21.9, P< 0.001)]. There was no interaction between hyponatraemia and the covariables on outcome in the multivariable models. ConclusionThe presence of hyponatraemia in outpatients with HF is associated with increased risk of hospitalization or death.

AB - Aim Hyponatraemia has been reported to be a potent predictor of poor outcome in patients hospitalized for heart failure (HF). The Aim of the study was to determine the prevalence and prognostic significance of hyponatraemia in a large cohort of HF outpatients followed in clinics participating in the Danish Heart Failure Clinics Network. Methods and resultsThe study population consisted of consecutive patients referred for HF management in 18 Danish heart failure clinics. Overall, 2863 patients (83) had a normal plasma sodium (p-sodium) level and 602 patients (17) had hyponatraemia with a p-sodium level <136 mmol/L. Outcome data were obtained from a validated, national registry. Patients were elderly with a mean age of 68 years. The mean P[Na] was 139.6 ± 2.4 mmol/L among patients with normonatraemia and 132.4 ± 3.2 mmol/L among patients with hyponatraemia. In multivariate Cox Proportional Hazard Models adjusted for confounders (age, gender, hospitalization within the last 90 days, loop diuretics, creatinine level, systolic blood pressure, New York Heart Association class IIIIV, left ventricular ejection fraction <0.46, ischaemic heart disease and diabetes) hyponatraemic patients had increased risk of hospitalization or death [hazard ratio (HR) 1.2 (95 confidence interval (CI) 1.01.4, P 0.011)]. Hyponatraemia was also an independent predictor of all-cause mortality [HR 1.5 (95 CI 1.21.9, P< 0.001)]. There was no interaction between hyponatraemia and the covariables on outcome in the multivariable models. ConclusionThe presence of hyponatraemia in outpatients with HF is associated with increased risk of hospitalization or death.

U2 - 10.1093/eurjhf/hfr086

DO - 10.1093/eurjhf/hfr086

M3 - Journal article

SN - 1567-4215

VL - 13

SP - 968

EP - 973

JO - European Journal of Heart Failure, Supplement

JF - European Journal of Heart Failure, Supplement

IS - 9

ER -