The prognostic value of hyponatremia in patients with Acute coronary syndrome

Abstract

Background: Hyponatremia is a common electrolyte disorder, and is associated with adverse outcomes in patients with acute coronary syndrome (ACS).

Aim: This study was designed to determine the relationship between hyponatremia at admission and in-hospital outcomes in patients with acute coronary syndrome.

Materials and Methods: This was a  cross - sectional study conducted at Al-Assad and Al-Mouassat University Hospitals, Damascus, during the period between September 2018 – September 2019.

Plasma sodium concentration was obtained in all patients at admission and analyzed as hyponatremia versus non-hyponatremi.

The relationships between hyponatremia and in-hospital mortality, arrhythmia, and heart failure were assessed.

Results: Of 144 patients with ACS, 25 (17.4%) patients had hyponatremia on presentation (sodium <135 meq/L). Patients with hyponatremia had higher rates of in-hospital arrhythmia (16% vs. 2.5%, p=0.004), heart failure (32% vs. 12.6%, p=0.016), and mortality (24% vs. 7.6%, p=0.014)

In multivariate logistic regression, hyponatremia was independently correlated with in-hospital arrhythmia (OR: 7.36, 95% CI: 1.5- 35.3, p=0.021), heart failure (OR: 3.26, 95% CI: 1.2- 8.86, p=0.02), and mortality (OR: 3.86, 95% CI: 1.23- 12, p=0.02).

Conclusion: Hyponatremia is independently associated with in-hospital adverse outcomes in patients with acute coronary syndrome.

Key words: Acute coronary syndrome, Hyponatremia, Outcomes.