Abstract

LAHUERTA, Ana Andrés et al. Prognostic impact of hyponatremia in patients receiving implantable cardioverter in primary prevention. Rev. Colomb. Cardiol. [online]. 2016, vol.23, n.1, pp.26-34. ISSN 0120-5633.  https://doi.org/10.1016/j.rccar.2015.06.009.

Introduction and objectives: Hyponatremia is a prognostic factor in patients with heart failure. Our objective was to assess the impact of hyponatremia in the evolution of patients undergoing cardioverter implantation in primary prevention. Method: This is a multicenter retrospective observational study in which serum sodium periimplant and adverse events (all-cause and cardiovascular mortality, first admission for heart failure, first appropriate and inappropriate therapy) were assessed in a Spanish cohort receiving cardioverter in primary prevention. Patients with mild hyponatremia (Na ≤ 135 mEq/L) and those with moderate to severe hyponatremia (Na ≤ 131 mEq/L) were compared to those without hyponatremia. Results: 725 patients, with a mean value of sodium in blood peri-implant of 139 ± 3.6 mEq/L and a mean follow-up was 34.1 ± 18.5 months. In patients with Na ≤ 135 mEq/L (n = 105), an increased incidence of first admission for heart failure was observed (Odds Ratio: 1.701; P = .031). In patients with moderate to severe hyponatremia (n = 18), higher total mortality (Hazard Ratio: 3.552; P = .002) and increased cardiovascular mortality (Hazard Ratio: 4.24; P = .003) were observed. None of those values of hyponatremia were associated with increased incidence of appropriate or inappropriate therapies Conclusions: Mild hyponatremia at the time of cardioverter implantation is related with a higher incidence of hospitalization for heart failure during follow-up, while moderate to severe hyponatremia increases the risk of death during follow-up.

Keywords : Defibrillator; Heart failure; Primary prevention.

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