The beneficial prognostic value of hemoconcentration is negatively affected by hyponatremia in acute decompensated heart failure: Data from the Korean Heart Failure (KorHF) Registry

Jaewon Oh, seokmin kang, In Cheol Kim, Seongwoo Han, Byungsu Yoo, Dong Ju Choi, Jae Joong Kim, Eun Seok Jeon, Myeong Chan Cho, Byung Hee Oh, Shung Chull Chae, Myung Mook Lee, Kyu Hyung Ryu

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background Hemoconcentration (HC) is associated with reduced mortality, whereas hyponatremia (HN) has been associated with an increased risk of adverse outcomes in patients with acute decompensated heart failure (ADHF). We sought to determine if the presence of HN influences the beneficial prognostic value of HC in ADHF patients. Methods We analyzed 2046 ADHF patients from the Korean Heart Failure Registry. We defined HC as an increased hemoglobin level from admission to discharge, and HN as sodium <135 mmol/L at admission. Our primary composite endpoint was all-cause mortality and/or HF re-hospitalization. Results Overall, HC occurred in 889 (43.5%) patients and HN was observed in 418 patients (20.4%). HC offered higher 2-year event-free survival in patients without HN (73.2% vs. 63.1% for no-HC, log-rank p < 0.001), but not in patients with HN (54.2% vs. 58.7% for no-HC, log-rank p = 0.879, p for interaction = 0.003). In a multiple Cox proportional hazard analysis, HC without HN conferred a significant event-free survival benefit (hazard ratio: 0.703, 95% confidence interval 0.542–0.912, p = 0.008) over no-HC with HN. Conclusions Only HC occurring in ADHF without HN was associated with improved clinical outcomes. These results provide further support for the importance of HN as a challenging therapeutic target in ADHF patients.

Original languageEnglish
Pages (from-to)790-796
Number of pages7
JournalJournal of Cardiology
Volume69
Issue number5
DOIs
Publication statusPublished - 2017 May 1

Fingerprint

Hyponatremia
Registries
Heart Failure
Disease-Free Survival
Mortality
Hemoglobins
Hospitalization
Sodium
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Oh, Jaewon ; kang, seokmin ; Kim, In Cheol ; Han, Seongwoo ; Yoo, Byungsu ; Choi, Dong Ju ; Kim, Jae Joong ; Jeon, Eun Seok ; Cho, Myeong Chan ; Oh, Byung Hee ; Chae, Shung Chull ; Lee, Myung Mook ; Ryu, Kyu Hyung. / The beneficial prognostic value of hemoconcentration is negatively affected by hyponatremia in acute decompensated heart failure : Data from the Korean Heart Failure (KorHF) Registry. In: Journal of Cardiology. 2017 ; Vol. 69, No. 5. pp. 790-796.
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abstract = "Background Hemoconcentration (HC) is associated with reduced mortality, whereas hyponatremia (HN) has been associated with an increased risk of adverse outcomes in patients with acute decompensated heart failure (ADHF). We sought to determine if the presence of HN influences the beneficial prognostic value of HC in ADHF patients. Methods We analyzed 2046 ADHF patients from the Korean Heart Failure Registry. We defined HC as an increased hemoglobin level from admission to discharge, and HN as sodium <135 mmol/L at admission. Our primary composite endpoint was all-cause mortality and/or HF re-hospitalization. Results Overall, HC occurred in 889 (43.5{\%}) patients and HN was observed in 418 patients (20.4{\%}). HC offered higher 2-year event-free survival in patients without HN (73.2{\%} vs. 63.1{\%} for no-HC, log-rank p < 0.001), but not in patients with HN (54.2{\%} vs. 58.7{\%} for no-HC, log-rank p = 0.879, p for interaction = 0.003). In a multiple Cox proportional hazard analysis, HC without HN conferred a significant event-free survival benefit (hazard ratio: 0.703, 95{\%} confidence interval 0.542–0.912, p = 0.008) over no-HC with HN. Conclusions Only HC occurring in ADHF without HN was associated with improved clinical outcomes. These results provide further support for the importance of HN as a challenging therapeutic target in ADHF patients.",
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The beneficial prognostic value of hemoconcentration is negatively affected by hyponatremia in acute decompensated heart failure : Data from the Korean Heart Failure (KorHF) Registry. / Oh, Jaewon; kang, seokmin; Kim, In Cheol; Han, Seongwoo; Yoo, Byungsu; Choi, Dong Ju; Kim, Jae Joong; Jeon, Eun Seok; Cho, Myeong Chan; Oh, Byung Hee; Chae, Shung Chull; Lee, Myung Mook; Ryu, Kyu Hyung.

In: Journal of Cardiology, Vol. 69, No. 5, 01.05.2017, p. 790-796.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The beneficial prognostic value of hemoconcentration is negatively affected by hyponatremia in acute decompensated heart failure

T2 - Data from the Korean Heart Failure (KorHF) Registry

AU - Oh, Jaewon

AU - kang, seokmin

AU - Kim, In Cheol

AU - Han, Seongwoo

AU - Yoo, Byungsu

AU - Choi, Dong Ju

AU - Kim, Jae Joong

AU - Jeon, Eun Seok

AU - Cho, Myeong Chan

AU - Oh, Byung Hee

AU - Chae, Shung Chull

AU - Lee, Myung Mook

AU - Ryu, Kyu Hyung

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Background Hemoconcentration (HC) is associated with reduced mortality, whereas hyponatremia (HN) has been associated with an increased risk of adverse outcomes in patients with acute decompensated heart failure (ADHF). We sought to determine if the presence of HN influences the beneficial prognostic value of HC in ADHF patients. Methods We analyzed 2046 ADHF patients from the Korean Heart Failure Registry. We defined HC as an increased hemoglobin level from admission to discharge, and HN as sodium <135 mmol/L at admission. Our primary composite endpoint was all-cause mortality and/or HF re-hospitalization. Results Overall, HC occurred in 889 (43.5%) patients and HN was observed in 418 patients (20.4%). HC offered higher 2-year event-free survival in patients without HN (73.2% vs. 63.1% for no-HC, log-rank p < 0.001), but not in patients with HN (54.2% vs. 58.7% for no-HC, log-rank p = 0.879, p for interaction = 0.003). In a multiple Cox proportional hazard analysis, HC without HN conferred a significant event-free survival benefit (hazard ratio: 0.703, 95% confidence interval 0.542–0.912, p = 0.008) over no-HC with HN. Conclusions Only HC occurring in ADHF without HN was associated with improved clinical outcomes. These results provide further support for the importance of HN as a challenging therapeutic target in ADHF patients.

AB - Background Hemoconcentration (HC) is associated with reduced mortality, whereas hyponatremia (HN) has been associated with an increased risk of adverse outcomes in patients with acute decompensated heart failure (ADHF). We sought to determine if the presence of HN influences the beneficial prognostic value of HC in ADHF patients. Methods We analyzed 2046 ADHF patients from the Korean Heart Failure Registry. We defined HC as an increased hemoglobin level from admission to discharge, and HN as sodium <135 mmol/L at admission. Our primary composite endpoint was all-cause mortality and/or HF re-hospitalization. Results Overall, HC occurred in 889 (43.5%) patients and HN was observed in 418 patients (20.4%). HC offered higher 2-year event-free survival in patients without HN (73.2% vs. 63.1% for no-HC, log-rank p < 0.001), but not in patients with HN (54.2% vs. 58.7% for no-HC, log-rank p = 0.879, p for interaction = 0.003). In a multiple Cox proportional hazard analysis, HC without HN conferred a significant event-free survival benefit (hazard ratio: 0.703, 95% confidence interval 0.542–0.912, p = 0.008) over no-HC with HN. Conclusions Only HC occurring in ADHF without HN was associated with improved clinical outcomes. These results provide further support for the importance of HN as a challenging therapeutic target in ADHF patients.

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