Introduction: There is lack of information regarding the mortality benefits between different medications in patients with permanent atrial fibrillation (AF). Purpose: We aimed to identify if there is any difference in mortality between the use of different rate controlling medications in patients with permanent AF. Methods: We identified patients with permanent AF without history of heart failure (HF) by using the TriNetX research database which provides information from electronic medical records from several health care institutions primarily based in the United States. Patients were divided in 4 cohorts, those taking metoprolol, diltiazem, carvedilol, or atenolol. Propensity score matching (PSM) was used to equilibrate the cohorts based on past medical history and medications. The cohorts were compared amongst each other after PSM. Results: There was no difference in mortality, emergency room visits, or hospitalizations with the use of different rate-controlling medications. Conclusion: This study suggests that there is no difference in mortality with the use of metoprolol, carvedilol, atenolol, or diltiazem in patients with permanent AF without history of HF.

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Introduction Hyponatremia is a common electrolyte abnormality that has been associated with poor outcomes in several conditions including acute myocardial infarction (AMI). However, those studies were performed in the era before percutaneous coronary intervention (PCI), focused mostly on ST-elevation myocardial infarction (STEMI), and sodium levels up to 72 h of admission. The purpose of this study was to identify the association between hyponatremia and clinical outcomes in patients with acute myocardial infarction. Methods We performed a retrospective analysis of patients with a diagnosis of non-ST-elevation myocardial infarction (NSTEMI) and STEMI presenting at our institution from March 2021 to September 2021. Our independent variables were sodium levels on the day of admission and up to 7 days later. Dependent variables were in-hospital mortality, 30-day mortality, length of hospital stay, intensive care admission, new heart failure diagnosis, and ejection fraction. Results 50.2% of patients had hyponatremia up to 7 days of admission. Intensive care admission was higher in patients with hyponatremia up to7 days (69.7% vs 54.3%, P 0.019, OR 1.9), they had worse 30-day mortality (12.7% vs to 2.2%, P 0.004, OR 6.5), in hospital mortality (9.9% vs 1.1%, P 0.006, OR 9.9), and new heart failure diagnosis (31.5% vs 17.9%, P < 0.043, OR 2.1). Hyponatremia on admission was associated with in-hopital mortality (16.3% vs 3.8%, P 0.004, OR 4.9), 30-day mortality (18.4% vs 5.9%, P 0.017, OR 3.5). Conclusions This study suggests that hyponatremia on admission and at any point during the first seven days of hospitalization are associated with in-hospital and 30-day mortality.