title: Three gram sodium intake is associated with longer event-free survival only in patients with advanced heart failure.
abstract: BACKGROUND
  There is limited evidence to support the recommendation that patients with heart failure (HF) restrict sodium intake. The purpose of this study was to compare differences in cardiac event-free survival between patients with sodium intake above and below 3 g.
  
  
  METHODS
  A total of 302 patients with HF (67% male, 62 ± 12 years, 54% New York Heart Association [NYHA] Class III/IV, ejection fraction 34 ± 14%) collected a 24-hour urine sodium (UNa) to indicate sodium intake. Patients were divided into 2 groups using a 3-g UNa cutpoint and stratified by NYHA Class (I/II vs. III/IV). Event-free survival for 12 months was determined by patient or family interviews and medical record review. Differences in cardiac event-free survival were determined by Kaplan-Meier survival curve with log-rank test and Cox hazard regression.
  
  
  RESULTS
  The Cox regression hazard ratio for 24-hour UNa ≥ 3 g in NYHA Class I/II was 0.44 (95% confidence interval [CI] = 0.20-0.97) and 2.54 (95% CI = 1.10-5.84) for NYHA III/IV after controlling for age, gender, HF etiology, body mass index, ejection fraction, and total comorbidity score.
  
  
  CONCLUSIONS
  These data suggest that 3 g dietary sodium restriction may be most appropriate for patients in NYHA functional Classes III and IV.
authors: University of Kentucky, College of Nursing, 751 Rose Street, Lexington, KY 40536, USA. tlennie@uky.edu
authors: Terry A
authors: TA
authors: Lennie
authors: Eun Kyeung
authors: EK
authors: Song
authors: Jia-Rong
authors: JR
authors: Wu
authors: Misook L
authors: ML
authors: Chung
authors: Sandra B
authors: SB
authors: Dunbar
authors: Susan J
authors: SJ
authors: Pressler
authors: Debra K
authors: DK
authors: Moser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004039:Diet, Sodium-Restricted; D018572:Disease-Free Survival; D005260:Female; D006333:Heart Failure / Q000178:diet therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012982:Sodium, Dietary / Q000008:administration & dosage*; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D012982:Sodium, Dietary