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Outcomes of correcting hyponatremia in patients with myocardial infarction

Waqas Qureshi1, Syed Hassan, Fatima Khalid

  • 1Department of Internal Medicine, Henry Ford Health Systems/Wayne State University School of Medicine, 2799 W Grand Blvd, CFP-1, Detroit, MI 48202, USA.

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|May 9, 2013
PubMed

Insights

Hyponatremia in myocardial infarction patients predicts mortality, whether corrected or persistent. However, correcting hyponatremia may improve survival, especially with vaptan use.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Clinical Research

Background:

  • Hyponatremia is a known predictor of poor outcomes in heart failure.
  • Its prognostic significance in myocardial infarction (MI) and the impact of correction remain unclear.

Purpose of the Study:

  • To assess the prognostic value of hyponatremia in MI patients.
  • To determine if correcting hyponatremia affects all-cause mortality.

Main Methods:

  • Retrospective analysis of 11,562 MI patients (2000-2010) with serum sodium measured within 24 hours of admission.
  • Multivariate and Cox proportional hazard models used to identify predictors of all-cause mortality and adjusted survival.

Main Results:

  • 1,535 deaths (13.3%) occurred over a mean follow-up of 5.5 years.
  • Both corrected (27.9% deaths) and persistent (55.3% deaths) hyponatremia independently predicted mortality (p < 0.0001).
  • Vaptan use was associated with reduced mortality in hyponatremic patients (HR 0.45; p=0.005).

Conclusions:

  • Hyponatremia, corrected or persistent, predicts mortality, major adverse cardiac events, and rehospitalization in MI patients.
  • Correction of hyponatremia can potentially improve patient survival.
  • Vaptans show promise in reducing mortality for hyponatremic MI patients.
Abstract

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