Short- and long-term prognostic value of hyponatremia in patients with acute coronary syndrome: A systematic review and meta-analysis

Ma, Qiang-Qiang; Fan, Xiude; Li, Tao; Hao, Yuanyuan; Ma, Feng

doi:10.1371/journal.pone.0193857

Cited by 26 publications

(16 citation statements)

References 42 publications

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“…Hyponatremia is a common electrolyte abnormality (29) which has been associated with an increased mortality in several conditions as myocardial infarction (30), hepatic cirrhosis (31) and pulmonary embolism (32). In cancer patients, hyponatremia is mainly coursed by the syndrome of inappropriate antidiuretic hormone secretion (SIADH) which may arise due to ectopic secretion of arginine vasopressin (33).…”

Section: Discussionmentioning

confidence: 99%

Hyponatremia as a prognostic factor in non-small cell lung cancer: a systematic review and meta-analysis

Sandfeld-Paulsen¹,

Aggerholm‐Pedersen²,

Winther‐Larsen³

2021

Transl Lung Cancer Res

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Background: Hyponatremia is a common electrolyte disorder in cancer patients and has been evaluated as a negative prognostic factor in several cancer types, especially in small cell lung cancer (SCLC). However, the prognostic value of hyponatremia is less studied in non-small cell lung cancer (NSCLC) patients. Therefore, we conducted a systematic review and meta-analysis to investigate the prognostic value of pretreatment hyponatremia in NSCLC patients. Methods:The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting checklist. The databases PubMed, Embase, Scopus, and Web of Science were searched on March 26th 2020 without time restrictions. The protocol was submitted to the PROSPERO database (ID 184612). Studies were included if they evaluated sodium level as a prognostic factor in NSCLC patients and contained original data published in English. Hazard ratios (HRs) for overall survival (OS) were pooled in a random-effects model.Results: Of 10,888 identified titles, 14 articles were included in the review including a total of 4,364 NSCLC patients. In 13 of the 14 articles, hyponatremia was found to be significantly correlated to a shorter OS. Ten articles were included in the meta-analysis. Here, patients with hyponatremia had a significantly shorter OS compared with patients with normal sodium level {pooled HR =2.02 [95% confidence interval (CI): 1.65-2.47]}. Two out of four studies found hyponatremia to be associated with a reduced progression free survival (PFS). Normalization of the sodium level during treatment was found to be associated with a prolonged PFS and OS in one study. Conclusions:This meta-analysis indicates that hyponatremia is a relative common condition in NSCLC patients associated with an increased mortality. Hence, sodium level could be a useful biomarker for stratifying NSCLC patients and thereby for preparing individual treatment plans.

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Section: Discussionmentioning

confidence: 99%

Hyponatremia as a prognostic factor in non-small cell lung cancer: a systematic review and meta-analysis

Sandfeld-Paulsen¹,

Aggerholm‐Pedersen²,

Winther‐Larsen³

2021

Transl Lung Cancer Res

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“…Normal symptoms for patients with hyponatremia include dizziness, disturbed alertness and confusion, which increases the risk of falls (29). Patients with hyponatremia have longer stays, more readmissions and increased mortality (30)(31)(32)39). One of the major causes of hyponatremia is diuretic therapy, often in combination with psychoactive drugs.…”

Section: Discussionmentioning

confidence: 99%

“…Electrolyte disturbances are also frequent among elderly patients, and hyponatremia is most common (28). Changes in electrolyte concentration affects alertness, reduces cognition (29) and increases mortality (30,31). For patients with chronic kidney disease, hyponatremia will worsen the prognosis (32).…”

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confidence: 99%

Risk factors for one-year all-cause mortality in elderly multimorbid medical in-patients.

Wang-Hansen

Kersten

Wyller³

2020

Preprint

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Background: Due to expansion of longevity, the proportion of elderly people with multimorbidity is increasing. Our aim was to identify risk factors for all-cause mortality in elderly multimorbid medical in-patients one year after acute hospitalization. Information regarding risk factors is important to support targeted care plans after discharge. Methods: Prospective cohort study of patients acutely admitted to a medical department in a Norwegian regional hospital. Eligible patients were community-dwelling, received home care services before hospitalization, were aged 75+, and suffered from two or more chronic conditions. Inclusion period was 1. April – 31. October 2012. Candidate variables were number of daily prescribed drugs, Cumulative Illness Rating Scale for Geriatrics score, delirium, body mass index (BMI), handgrip strength, Barthel Activities of Daily Living Index score, and the laboratory analyses haemoglobin (Hgb), sodium (Na) and estimated glomerular filtration rate (eGFR). Results: We included 227 patients; mean age 86 years, 59% women, 71% lived alone. During the year after hospitalization, 39% died. In the adjusted cox proportional hazards regression analysis, significant and independent risk factors were BMI (hazard ratio (HR) 0.93, 95% confidence interval (CI) 0.88-0.98 per kg/m2), Hgb (HR 0.87, 95% CI 0.76-0.98 per g/100 mL), Na (HR 0.94, 95% CI 0.90-0.99 per mmol/L) and eGFR < 60 mL/min/1.73 m2 (HR 1.82, 95% CI 1.07-3.08).Conclusions: In this cohort of multimorbid elderly internal medicine patients, low body mass, hyponatremia, impaired renal function and anaemia were identified as independent and significant risk factors for one-year mortality.

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“…Однако многими авторами подчеркивается наличие диапазона потребления натрия с пищей, при котором риск минимален, а превышение или, наоборот, снижение поступления хлорида натрия в организм приводит к значительному увеличению ССР [7]. Изучение влияния изменения уровня натрия в сыворотке крови на смертность при различных сердечно-сосудистых заболеваниях и у здоровых лиц также демонстрирует U-образную зависимость [8]. Анализ взаимосвязи натрийурии со смертностью не до конца изучен в популяции больных с сердечно-сосудистой патологией, особенно при ОКС.…”

Section: Discussionunclassified

Influence of electrolyte balance on the prognosis of long-term cardiovascular events after acute coronary syndrome

Левицкая

Батюшин

Gulchenko³

et al. 2020

Cardiovasc Ther Prev

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Aim. To assess the effect of electrolyte changes on the prognosis of long-term cardiovascular events after acute coronary syndrome (ACS).Material and methods. The study included 105 patients with ACS who underwent coronary angiography (CA) with coronary stenting. At the study inclusion (before CA with coronary stenting), we collected data on traditional risk factors, analyzed levels of urinary sodium and potassium, kaliuresis and natriuresis. Free water clearance (FWC) and electrolyte free water clearance (EFWC), as well as fluid balance using bioelectrical impedance analysis were determined. Study endpoints (fatal and nonfatal cardiovascular events) were determined 6,2±0,2 months after CA with coronary stenting.Results. It was found that a decrease in urinary sodium (χ2=5,64, p=0,02, Constanta B0 =-0,62, Estimate =-16,5) and natriuresis (χ2=4,1, р=0,044, Constanta B0 =-1,38, Estimate =-5,2) increase the death risk. Urinary sodium of 0,2 mol/L and natriuresis of 0,5 mol are threshold levels of increased risk of death. Urinary potassium decrease was associated with an increase in death risk (threshold level — 0,5 mol/L, χ2=4,99, р=0,025, Constanta B0 =-0,63, Estimate =-70,4) and acute myocardial infarction (threshold level — 0,06 mol/L, χ2=3,93, р=0,04, Constanta B0 =-0,99, Estimate =-58,0) in the long-term period. Increase in EFWC increased the likelihood of long-term transient ischemic attack after ACS (χ2=4,61, р=0,03, Constanta B0 =-2,95, Estimate =-1,0). There were no significant relationships in the matter of FWC (p>0,05). However, with a decrease in intracellular fluid volume compared to normal values and a decrease in FWC or an increase in EFWC, the likelihood of longterm composite endpoints after ACS increases.Conclusion. As a result of the study, risk markers for long-term fatal and non-fatal cardiovascular events after ACS were established: decrease in urinary sodium <0,2 mol/l and potassium <0,5 mol/l; decrease in FWC and increase in EFWC with or without cellular dehydration. The established markers can complement the current cardiovascular risk score methods in patients with ACS.

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Short- and long-term prognostic value of hyponatremia in patients with acute coronary syndrome: A systematic review and meta-analysis

Cited by 26 publications

References 42 publications

Hyponatremia as a prognostic factor in non-small cell lung cancer: a systematic review and meta-analysis

Hyponatremia as a prognostic factor in non-small cell lung cancer: a systematic review and meta-analysis

Risk factors for one-year all-cause mortality in elderly multimorbid medical in-patients.

Influence of electrolyte balance on the prognosis of long-term cardiovascular events after acute coronary syndrome

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