title: Renal function, serum sodium level, and outcomes in hospitalized systolic heart failure patients: An analysis of the COAST study.
abstract: Both renal function and serum sodium level are well-known prognostic markers in heart failure (HF) patients. We investigated the prognostic value of the renal impairment (RI) stratified by the serum sodium level in systolic HF patients.The Clinical Characteristics and Outcomes in Relation with Serum Sodium Level in Asian Patients Hospitalized for Heart Failure (the COAST) Study enrolled hospitalized systolic HF patients (ejection fraction<45%) in South Korea, Taiwan, and China. Twelve-month mortality was stratified according to the renal function and serum sodium level.Of 1462 enrolled patients, 716 patients (49%) had RI (GFR<60 mL/min/1.73 m), and they had higher 12-month mortality than those without RI (22.8% vs. 10.9%, P<0.001). Furthermore, 676 patients (46%) had low sodium level defined as Na<median, that was, 139 mmol/L. The mortality rate was lowest in patients with normal renal function and high sodium level (7.4%), but highest in those with RI and low sodium level (26.1%) (P<0.001). Patients with both RI and low sodium level had a 3.8-times increased hazard for 12-month mortality (HR 3.80, 95% CI 2.06-7.05), whereas the low sodium level (HR, 2.95; 95% CI, 1.51-5.75) and RI (HR 3.08; 95% CI, 1.63-5.82) had similar hazard, suggesting that they might be equivalent risk factors.In hospitalized Asian HF-patients both RI and low sodium level are independent risk factors. Patients with both RI and low serum sodium level are at the highest risk and may require meticulous medical care.
authors.affiliation: Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, South Korea Severance Hospital, Yonsei University Health System, Seoul, Korea Yonsei University Wonju College of Medicine, Wonju Christian Hospital, Wonju, South Korea National Taiwan University Hospital, Taipei City, Taiwan Taipei Veterans General Hospital, Taipei City, Taiwan Chang Gung Memorial Hospital, Linkou, Taiwan Fuwai Hospital, Beijing, China Zhongshan Hospital, Shanghai, China.
authors.forename: Jin Joo
authors.initials: JJ
authors.lastname: Park
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Chae
authors.forename: Dong-Ju
authors.initials: DJ
authors.lastname: Choi
authors.forename: Seok-Min
authors.initials: SM
authors.lastname: Kang
authors.forename: Byung-Su
authors.initials: BS
authors.lastname: Yoo
authors.forename: Juey-Jen
authors.initials: JJ
authors.lastname: Hwang
authors.forename: Shing-Jong
authors.initials: SJ
authors.lastname: Lin
authors.forename: Ming-Shien
authors.initials: MS
authors.lastname: Wen
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.forename: Junbo
authors.initials: J
authors.lastname: Ge
mesh_terms: D000368:Aged; D002681:China / Q000453:epidemiology; D005260:Female; D054143:Heart Failure, Systolic / Q000097:blood* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D051437:Renal Insufficiency / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012964:Sodium / Q000097:blood*; D013318:Stroke Volume / Q000502:physiology*; D015996:Survival Rate / Q000639:trends; D013624:Taiwan / Q000453:epidemiology
chemical_list: D012964:Sodium