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Hyponatremia at discharge is associated with adverse prognosis in acute heart failure syndromes with preserved ejection fraction : a report from the JASPER registry

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Title: Hyponatremia at discharge is associated with adverse prognosis in acute heart failure syndromes with preserved ejection fraction : a report from the JASPER registry
Authors: Sato, Yu Browse this author
Yoshihisa, Akiomi Browse this author →KAKEN DB
Oikawa, Masayoshi Browse this author →KAKEN DB
Nagai, Toshiyuki Browse this author →KAKEN DB
Yoshikawa, Tsutomu Browse this author
Saito, Yoshihiko Browse this author →KAKEN DB
Yamamoto, Kazuhiro Browse this author →KAKEN DB
Takeishi, Yasuchika Browse this author →KAKEN DB
Anzai, Toshihisa Browse this author →KAKEN DB
Keywords: Heart failure with preserved ejection fraction
prognosis
hyponatremia
sodium
Issue Date: Oct-2019
Publisher: SAGE Publications
Journal Title: European heart journal, Acute cardiovascular care
Volume: 8
Issue: 7
Start Page: 623
End Page: 633
Publisher DOI: 10.1177/2048872618822459
Abstract: Introduction: Hyponatremia predicts adverse prognosis in patients with heart failure in particular with reduced ejection fraction. In contrast, it has recently been reported that hyponatremia on admission is not a predictor of post-discharge mortality in patients with heart failure with preserved ejection fraction. We investigated the prognostic impact of hyponatremia at discharge in patients with heart failure with preserved ejection fraction and its clinical characteristics. Methods and results: The Japanese Heart Failure Syndrome with Preserved Ejection Fraction (JASPER) registry is a nationwide, observational, prospective registration of consecutive Japanese patients hospitalised with heart failure with preserved ejection fraction and left ventricular ejection fraction of 50% or greater. Five hundred consecutive patients were enrolled in this analysis. We divided the patients into two groups based on their sodium serum levels at discharge: hyponatremia group (sodium <135 mEq/L, n=50, 10.0%) and control group (sodium > 135 mEq/L, n=450, 90.0%). This present analysis had two primary endpoints: all-cause death and all-cause death or rehospitalisation for heart failure. At discharge, the hyponatremia group had lower systolic blood pressure (110.0 mmHg vs. 114.5 mmHg, P=0.014) and higher levels of urea nitrogen (31.9 mg/dL vs. 24.2 mg/dL, P=0.032). In the Kaplan-Meier analysis, more patients in the hyponatremia group reached the primary endpoints than those in the control group (log rank <0.01, respectively). In the Cox proportional hazard analysis, hyponatremia at discharge was a predictor of the two endpoints (all-cause death, hazard ratio 2.708, 95% confidence interval 1.557-4.708, P<0.001; all-cause death or rehospitalisation for heart failure, hazard ratio 1.829, 95% confidence interval 1.203-2.780, P=0.005). Conclusions: Hyponatremia at discharge is associated with adverse prognosis in hospitalised patients with heart failure with preserved ejection fraction.
Rights: Yu Sato, Akiomi Yoshihisa, Masayoshi Oikawa, Toshiyuki Nagai, Tsutomu Yoshikawa, Yoshihiko Saito, Kazuhiro Yamamoto, Yasuchika Takeishi, Toshihisa Anzai, Hyponatremia at discharge is associated with adverse prognosis in acute heart failure syndromes with preserved ejection fraction: a report from the JASPER registry, European heart journal, Acute cardiovascular care pp. 623-633. Copyright c 2019 The European Society of Cardiology.DOI: 10.1177/2048872618822459.
Type: article (author version)
URI: http://hdl.handle.net/2115/76201
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 安斉 俊久

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