Hyponatremia in patients with acute myocardial infarction tied to mortality risk: BMC
USA: Hyponatremia on admission and at any points within first 7 days of hospitalization in patients with acute myocardial infarction is associated with in-hospital and 30-day mortality, says a new study published in BMC Cardiovascular Disorders.
Hyponatremia is a common electrolyte abnormality whose presence leads to poor outcomes in several conditions including acute myocardial infarction (AMI). Those studies, however, were performed in the era before percutaneous coronary intervention (PCI), centered mostly on ST-elevation myocardial infarction (STEMI), and sodium levels up to 72 h of admission.
Against the above background, Andres Cordova Sanchez, Department of Medicine, SUNY Upstate Medical University, NY, USA, and colleagues aimed to identify the association between hyponatremia and clinical outcomes in patients with acute myocardial infarction.
For this purpose, the researchers performed a retrospective analysis of patients presenting with a diagnosis of non-ST-elevation myocardial infarction (NSTEMI) and STEMI between March 2021 to September 2021. Sodium levels on the day of admission and up to 7 days later were the independent variables. Dependent variables were 30-day mortality, in-hospital mortality, intensive care admission, length of hospital stay, ejection fraction, and new heart failure diagnosis.
Following were the findings of the study:
· 50.2% of patients had hyponatremia up to 7 days of admission.
· Intensive care admission was higher in patients with hyponatremia up to7 days (69.7% vs 54.3%), they had worse 30-day mortality (12.7% vs to 2.2%), in hospital mortality (9.9% vs 1.1%), and new heart failure diagnosis (31.5% vs 17.9%).
· Hyponatremia on admission was associated with in-hopital mortality (16.3% vs 3.8%), 30-day mortality (18.4% vs 5.9%).
The researchers conclude, "the findings suggests that hyponatremia on admission and at any point during the first seven days of hospitalization are associated with in-hospital and 30-day mortality."
Cordova Sanchez, A., Bhuta, K., Shmorgon, G. et al. The association of hyponatremia and clinical outcomes in patients with acute myocardial infarction: a cross-sectional study. BMC Cardiovasc Disord 22, 276 (2022). https://doi.org/10.1186/s12872-022-02700-y