Relationship between admission serum sodium concentration and clinical outcomes in patients hospitalized for heart failure: an analysis from the OPTIMIZE-HF registry.
Mihai Gheorghiade,William T. Abraham,Nancy M. Albert,Wendy Gattis Stough,Wendy Gattis Stough,Barry H. Greenberg,Christopher M. O'Connor,Lilin She,Clyde W. Yancy,James B. Young,Gregg C. Fonarow +10 more
TLDR
Hyponatraemia in hospitalized patients with heart failure is relatively common and is associated with longer hospital stays and higher in-hospital and early post-discharge mortality.Abstract:
Aims Hyponatraemia has been shown to be an independent predictor of mortality in selected patients with heart failure enrolled in clinical trials. The predictive value of hyponatraemia has not been evaluated in unselected patients hospitalized with heart failure.
Methods and results OPTIMIZE-HF is a registry and performance-improvement programme for patients hospitalized with heart failure and includes a subgroup with 60–90 day follow-up data. The relationship between admission serum sodium concentration and clinical outcomes was analysed in 48 612 patients from 259 hospitals. Admission serum sodium levels were analysed both as a continuous variable and by grouping patients with admission Na <135 and Na ≥ 135 mmol/L. Patients with hyponatraemia (Na <135 mmol/L) at the time of hospital admission had modest differences in baseline clinical characteristics and management during hospitalization compared with patients who had serum sodium ≥135 mmol/L. Patients with hyponatraemia were more likely to be Caucasian, have lower admission systolic blood pressure, and receive intravenous inotropes during hospitalization. Patients with hyponatraemia had significantly higher rates of in-hospital and follow-up mortality and longer hospital stays, although no difference in re-admission rates was observed. After adjusting for differences with multivariable analysis, the risk of in-hospital death increased by 19.5%, the risk of follow-up mortality by 10%, and the risk of death or rehospitalization by 8% for each 3 mmol/L decrease in admission serum sodium below 140 mmol/L.
Conclusion Hyponatraemia in hospitalized patients with heart failure is relatively common and is associated with longer hospital stays and higher in-hospital and early post-discharge mortality. Re-admission rates were equally high in patients with or without hyponatraemia.read more
Citations
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2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
Clyde W. Yancy,Mariell Jessup,Biykem Bozkurt,Javed Butler,Donald E. Casey,Mark H. Drazner,Gregg C. Fonarow,Stephen A. Geraci,Tamara B. Horwich,James L. Januzzi,Maryl R. Johnson,Edward K. Kasper,Wayne C. Levy,Frederick A. Masoudi,Patrick E. McBride,John J.V. McMurray,Judith E. Mitchell,Pamela N. Peterson,Barbara Riegel,Flora Sam,Lynne W. Stevenson,W.H. Wilson Tang,Emily J. Tsai,Bruce L. Wilkoff +23 more
TL;DR: In this article, Anderson et al. proposed a new FAHA Chair, Jeffrey L. Anderson, MD, FACC, FAHA, Chair-Elect, Alice K. Jacobs et al., this article and Biykem Bozkurt.
Journal ArticleDOI
Narrative review: the management of acute decompensated heart failure.
Paul E. Marik,Mark Flemmer +1 more
TL;DR: Evidence-based recommendations are provided for the diagnosis and management of acute decompensated heart failure including morphine, high-dose diuretics, and inotropic agents may be harmful.
Journal ArticleDOI
The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries.
Andrew P. Ambrosy,Gregg C. Fonarow,Javed Butler,Ovidiu Chioncel,Stephen J. Greene,Muthiah Vaduganathan,Savina Nodari,Carolyn S.P. Lam,Naoki Sato,Ami N. Shah,Mihai Gheorghiade +10 more
TL;DR: Global HHF registries are reviewed to describe the patient characteristics, management, outcomes and their predictors, quality improvement initiatives, regional differences, and limitations of the available data and propose a roadmap for the design and conduct of future H HF registries.
Journal ArticleDOI
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.
Paul A. Heidenreich,Biykem Bozkurt,David Aguilar,Larry A. Allen,Joni J. Byun,Monica Colvin,Anita Deswal,Mark H. Drazner,Shannon M. Dunlay,Linda R. Evers,James C. Fang,Savitri Fedson,Gregg C. Fonarow,Salim S. Hayek,Adrian F. Hernandez,Prateeti Khazanie,Michelle M. Kittleson,Christopher S. Lee,Mark S. Link,Carmelo A. Milano,Lorraine C. Nnacheta,Alexander T. Sandhu,Lynne W. Stevenson,Orly Vardeny,Amanda R. Vest,Clyde W. Yancy +25 more
TL;DR: The "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure" as discussed by the authors provides patient-centric recommendations for clinicians to prevent, diagnose, and manage patients with heart failure.
Journal ArticleDOI
Clinical practice guideline on diagnosis and treatment of hyponatraemia
Goce Spasovski,Raymond Vanholder,Bruno Allolio,Djillali Annane,Steve S. Ball,Daniel G. Bichet,Guy Decaux,Wiebke W. Fenske,Ewout J. Hoorn,Carole Ichai,Michael Joannidis,Alain Soupart,Robert Zietse,Maria M. Haller,Sabine S. Van Der Veer,Wim Van Biesen,E Nagler +16 more
TL;DR: The Clinical Practice Guideline on the diagnostic approach and treatment of hyponatraemia is developed as a joint venture of three societies representing specialists with a natural interest in hyponatonemia to obtain a common and holistic view.
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Journal ArticleDOI
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Journal ArticleDOI
Effects of Tolvaptan, a Vasopressin Antagonist, in Patients Hospitalized with Worsening Heart Failure: A Randomized Controlled Trial
Mihai Gheorghiade,Wendy A. Gattis,Christopher M. O'Connor,Kirkwood F. Adams,Uri Elkayam,Alejandro Barbagelata,Jalal K. Ghali,Raymond L. Benza,Frank McGrew,Marc Klapholz,John Ouyang,Cesare Orlandi +11 more
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