HEART FAILURE CLINICAL OUTCOMES IN HYPONATREMIC VERSUS NORMONATREMIC PATIENTS

Objective: To compare the outcome in heart failure patients between normonatremic and hyponatremic cases in the short term. Methodology: A cross-sectional study focusing on descriptive statistics at the Department of Cardiology, Lady Reading Hospital Peshawar was performed from 9th August 2011, till 29th April, 2012. Both male and female patients aged 14 years and above admitted diagnosed with heart failure were enrolled and data observed. Those having serum sodium of ≤135mmol/L were defined as hyponatremic. All the patients were managed according to guidelines. All patients were followed during their hospital stay. Patients who survived were discharged on standard HF medications and followed till the end of third month for 3 month mortality and re-admissions for heart failure. Results: Total study population was 241. Mean age was 59.2 ± 14.9 (18-100) years. Female patients were 51% (123). Mean serum sodium was 136±5.1mmol/L (116-151). Hyponatremia was present in 35.3% (85) patients. Overall three month follow up mortality was 14.7%, while it was significantly higher in hyponatremic group 22.7% compared to normonatremic patients 10.7% (P=0.02). Being followed for a period of 3 months 25% patients were readmitted to hospital with heart failure decompensation. Hyponatremic group had readmission rate of 26.7% compared with 24% in normonatremic patients (p=0.74). Conclusions: Hyponatremia in patients diagnosed with heart failure possess a significant over all risk to a higher mortality as compared to those that are normonatremic. Re-admissions for heart failure are equally common in hyponatremic and normonatremic patients.