The Early Prognostic Value of Serum Sodium Level in Patients With Acute ST-elevation Myocardial Infarction
10.3969/j.issn.1000-3614.2017.08.004
- VernacularTitle:血清钠水平对急性ST段抬高型心肌梗死患者近期预后的预测价值
- Author:
Tao ZHANG
;
Yanmin YANG
;
Jun ZHU
;
Lisheng LIU
;
Yan LIANG
;
Huiqiong TAN
;
Jiandong LI
- Keywords:
Myocardial Infarction;
Hyponatremia;
Prognosis
- From:
Chinese Circulation Journal
2017;32(8):742-747
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the relationship between serum sodium level and early prognosis in patients with acute ST-elevation myocardial infarction (STEMI). Methods: A total of 7461 STEMI patients within 12h of onset who matched the diagnostic standard of European society of cardiology and American college of cardiology were retrospectively studied. According to serum sodium levels within 24h of admission, the patients were categorized into 3 groups: Serum sodium≥135 mmol/L group, Serum sodium 130-134 mmol/L group and Serum sodium<130 mmol/L group. The baseline condition, 30-day mortality with other adverse events and the effect of neuroendocriology inhibitor treatment were compared among 3 groups; their relationships to serum sodium level were analyzed. Results: Serum sodium<130 mmol/L group had the higher 7-day and 30-day mortality than the other 2 groups, both P<0.001; compared with Serum sodium≥135 mmol/L group, Serum sodium<130 mmol/L group presented the higher occurrence rates of 30-day cardiac shock, heart failure (HF) and life-threatening arrhythmia, P<0.001. With adjusted affecting factors of age, diuretic and reperfusion treatments, serum sodium<130 mmol/L was still related to 7-day and 30-day mortality (OR=1.69 and OR=1.57). Both single and multivariable analysis indicated that serum sodium<130 mmol/L was related to cardiac shock (OR=1.75 and OR=1.64), HF (OR=1.42 and OR=1.30) and life-threatening arrhythmia (OR=1.53 and OR=1.34). In all 3 groups, the patients using ACE inhibitor, β-blocker or both medications had reduced 30-day mortality than those without such medication, allP<0.001; the reduction was more obvious in Serum sodium<130 mmol/L group than the other 2 groups,P<0.001. Conclusion: Serum sodium level<130 mmol/L within 24h of admission was the risk factor for the early stage main adverse events as mortality, cardiac shock, HF and life-threatening arrhythmia in acute STEMI patients.
