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Prognostic value of hyponatremia in heart failure patients: an analysis of the Clinical Characteristics and Outcomes in the Relation with Serum Sodium Level in Asian Patients Hospitalized for Heart Failure (COAST) study

The Korean journal of internal medicine, 2015-07, Vol.30 (4), p.460-470 [Peer Reviewed Journal]

COPYRIGHT(C) KYOBO BOOK CENTRE ALL RIGHTS RESERVED ;ISSN: 1226-3303 ;EISSN: 2005-6648

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  • Title:
    Prognostic value of hyponatremia in heart failure patients: an analysis of the Clinical Characteristics and Outcomes in the Relation with Serum Sodium Level in Asian Patients Hospitalized for Heart Failure (COAST) study
  • Author: Byung Su Yoo ; Jin Joo Park ; Dong Ju Choi ; Seok Min Kang ; Juey Jen Hwang ; Shing Jong Lin ; Ming Shien Wen ; Jian Zhang ; Junbo Ge
  • Subjects: East Asians ; Hospitalized heart failure ; Hyponatremia ; Predictor of clinical outcomes
  • Is Part Of: The Korean journal of internal medicine, 2015-07, Vol.30 (4), p.460-470
  • Description: Background/Aims: Hyponatremia is a well-known risk factor for poor outcomes in Western studies of heart failure (HF) patients. We evaluated the predictive value of hyponatremia in hospitalized Asian HF patients. Methods: The Clinical Characteristics and Outcomes in the Relation with Serum Sodium Level in Asian Patients Hospitalized for Heart Failure (the COAST) study enrolled hospitalized patients with systolic HF (ejection fraction < 45%) at eight centers in South Korea, Taiwan, and China. The relationship between admissionsodium level and clinical outcomes was analyzed in 1,470 patients. Results: The mean admission sodium level was 138 ± 4.7 mmol/L, and 247 patients (16.8%) had hyponatremia defined as Na+ < 135 mmol/L. The 12-month mortality was higher in hyponatremic patients (27.9% vs. 14.6%, p < 0.001), and hyponatremia was an independent predictor of 12-month mortality (hazard ratio, 1.72; 95% confidence interval, 1.12 to 2.65). During hospital admission, 57% of hyponatremic patients showed improvement without improvement in their clinical outcomes (p = 0.620). The proportion of patients with optimal medical treatment was only 26.5% and 44.2% at admission and discharge, respectively, defined as thecombined use of angiotensin-converting-enzyme inhibitor/angiotensin receptor blocker and β-blocker. Underuse of optimal medical treatment was more pronounced in hyponatremic patients. Conclusions: In hospitalized Asian HF patients, hyponatremia at admission is common and is an independent predictor of poor clinical outcome. Furthermore, hyponatremic patients receive less optimal medical treatment than their counterparts.
  • Publisher: 대한내과학회
  • Language: Korean
  • Identifier: ISSN: 1226-3303
    EISSN: 2005-6648
  • Source: KoreaMed Synapse
    PubMed Central
    ROAD: Directory of Open Access Scholarly Resources
    DOAJ Directory of Open Access Journals
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