Can we use plasma hyperosmolality as a predictor of mortality for ST-segment elevation myocardial infarction?
BACKGROUND
The aim of this study was to investigate the association of plasma osmolality with all-cause mortality in ST-segment elevation myocardial infarction (STEMI) patients treated with a primary percutaneous coronary intervention.


METHODS
This study included 3748 patients (mean age 58.3±11.8 years, men 81%) with STEMI treated with primary percutaneous coronary intervention. The following formula was used to measure the plasma osmolality at admission: osmolality=1.86×sodium (mmol/l)+glucose (mg/dl)/18+BUN (mg/dl)/2.8+9.


RESULTS
The patients were followed up for a mean period of 22±10 months. Patients with higher plasma osmolality had 3.7 times higher in-hospital (95% confidence interval: 2.7-5.1) and 3.2 times higher long-term (95% confidence interval: 2.5-4.1) all-cause mortality rates than patients with lower plasma osmolality.


CONCLUSIONS
Plasma osmolality was found to be a predictor of both in-hospital and long-term all-cause mortality. Hence, plasma osmolality can be used to detect high-risk patients in STEMI.
aDepartment of Cardiovascular Science, Texas A&M Institute for Preclinical Science, College Station, Texas, USA bDepartment of Cardiology, Suruc State Hospital, Urfa cDepartment of Cardiology, Dr Siyami Ersek Cardiovascular Surgery Research and Training Hospital dDepartment of Family Medicine, Yenidogan Public Health Center, Istanbul, Turkey.
Mustafa A
MA
Tatlisu
Adnan
A
Kaya
Muhammed
M
Keskin
Osman
O
Uzman
Edibe B
EB
Borklu
Goksel
G
Cinier
Mert I
MI
Hayiroglu
Kiymet
K
Tatlisu
Mehmet
M
Eren
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001806:Blood Urea Nitrogen; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009994:Osmolar Concentration; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality*; D010949:Plasma; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D012964:Sodium / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D001786:Blood Glucose; D012964:Sodium