title: The beneficial prognostic value of hemoconcentration is negatively affected by hyponatremia in acute decompensated heart failure: Data from the Korean Heart Failure (KorHF) Registry.
abstract: 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.
  
  
  
  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 <135mmol/L at admission. Our primary composite endpoint was all-cause mortality and/or HF re-hospitalization.
  
  
  
  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.
  
  
  
  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.
authors: Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Seoul, Republic of Korea.
authors: Jaewon
authors: J
authors: Oh
authors: Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Seoul, Republic of Korea. Electronic address: smkang@yuhs.ac.
authors: Seok-Min
authors: SM
authors: Kang
authors: Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Seoul, Republic of Korea.
authors: In-Cheol
authors: IC
authors: Kim
authors: Division of Cardiology, Hallym University Medical Center, Hwaseong, Republic of Korea.
authors: Seongwoo
authors: S
authors: Han
authors: Division of Cardiology, Yonsei University Wonju Severance Christian Hospital, Wonju, Republic of Korea.
authors: Byung-Su
authors: BS
authors: Yoo
authors: Division of Cardiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors: Dong-Ju
authors: DJ
authors: Choi
authors: Division of Cardiology, Ulsan University Asan Medical Center, Seoul, Republic of Korea.
authors: Jae-Joong
authors: JJ
authors: Kim
authors: Division of Cardiology, Sungkyunkwan University Samsung Medical Center, Seoul, Republic of Korea.
authors: Eun-Seok
authors: ES
authors: Jeon
authors: Division of Cardiology, Chungbuk National University Hospital, Cheongju, Republic of Korea.
authors: Myeong-Chan
authors: MC
authors: Cho
authors: Division of Cardiology, Seoul National University Hospital, Seoul, Republic of Korea.
authors: Byung-Hee
authors: BH
authors: Oh
authors: Division of Cardiology, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors: Shung Chull
authors: SC
authors: Chae
authors: Division of Cardiology, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.
authors: Myung-Mook
authors: MM
authors: Lee
authors: Division of Cardiology, Hallym University Medical Center, Hwaseong, Republic of Korea.
authors: Kyu-Hyung
authors: KH
authors: Ryu
mesh_terms: D000368:Aged; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000401:mortality*; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007010:Hyponatremia / Q000150:complications*; D008297:Male; D010359:Patient Readmission; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology
chemical_list: D006454:Hemoglobins
keywords: Heart failure; Hemoglobin; Prognosis; Sodium