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The beneficial prognostic value of hemoconcentration is negatively affected by hyponatremia in acute decompensated heart failure: Data from the Korean Heart Failure (KorHF) Registry

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Author(s)
Jaewon OhSeok-Min KangIn-Cheol KimSeongwoo HanByung-Su YooDong-Ju ChoiJae-Joong KimEun-Seok JeonMyeong-Chan ChoByung-Hee OhShung Chull ChaeMyung-Mook LeeKyu-Hyung Ryu
Keimyung Author(s)
Kim, In Cheol
Department
Dept. of Internal Medicine (내과학)
Journal Title
Journal of Cardiology
Issued Date
2017
Volume
69
Issue
5
Keyword
Heart failureHemoglobinSodiumPrognosis
Abstract
Background : Hemoconcentration (HC) is associated with reduced mortality, whereas hyponatremia (HN) has been associated with an increased risk of adverse outcomes in patients with acute decompensated heart failure (ADHF). We sought to determine if the presence of HN influences the beneficial prognostic value of HC in ADHF patients.
Methods : We analyzed 2046 ADHF patients from the Korean Heart Failure Registry. We defined HC as an increased hemoglobin level from admission to discharge, and HN as sodium <135 mmol/L at admission. Our primary composite endpoint was all-cause mortality and/or HF re-hospitalization.
Results : Overall, HC occurred in 889 (43.5%) patients and HN was observed in 418 patients (20.4%). HC offered higher 2-year event-free survival in patients without HN (73.2% vs. 63.1% for no-HC, log-rank p < 0.001), but not in patients with HN (54.2% vs. 58.7% for no-HC, log-rank p = 0.879, p for interaction = 0.003). In a multiple Cox proportional hazard analysis, HC without HN conferred a significant event-free survival benefit (hazard ratio: 0.703, 95% confidence interval 0.542–0.912, p = 0.008) over no-HC with HN.

Conclusions : Only HC occurring in ADHF without HN was associated with improved clinical outcomes. These results provide further support for the importance of HN as a challenging therapeutic target in ADHF patients.
Keimyung Author(s)(Kor)
김인철
Publisher
School of Medicine
Citation
Jaewon Oh et al. (2017). The beneficial prognostic value of hemoconcentration is negatively affected by hyponatremia in acute decompensated heart failure: Data from the Korean Heart Failure (KorHF) Registry. Journal of Cardiology, 69(5), 790–796. doi: 10.1016/j.jjcc.2016.08.003
Type
Article
ISSN
0914-5087
DOI
10.1016/j.jjcc.2016.08.003
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32444
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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