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The beneficial prognostic value of hemoconcentration is negatively affected by hyponatremia in acute decompensated heart failure: Data from the Korean Heart Failure (KorHF) Registry.

 Jaewon Oh  ;  Seok-Min Kang  ;  In-Cheol Kim  ;  Seongwoo Han  ;  Byung-Su Yoo  ;  Dong-Ju Choi  ;  Jae-Joong Kim  ;  Eun-Seok Jeon  ;  Myeong-Chan Cho  ;  Byung-Hee Oh  ;  Shung Chull Chae  ;  Myung-Mook Lee  ;  Kyu-Hyung Ryu 
 Journal of Cardiology, Vol.69(5) : 790-796, 2017 
Journal Title
 Journal of Cardiology 
Issue Date
Aged ; Female ; Heart Failure/complications ; Heart Failure/mortality* ; Hemoglobins/analysis* ; Humans ; Hyponatremia/complications* ; Male ; Patient Readmission ; Prognosis ; Proportional Hazards Models ; Registries ; Republic of Korea/epidemiology
Heart failure ; Hemoglobin ; Prognosis ; Sodium
Background : 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. Methods : 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 <135 mmol/L at admission. Our primary composite endpoint was all-cause mortality and/or HF re-hospitalization. Results : 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. Conclusions : 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.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Kim, In Cheol(김인철)
Oh, Jae Won(오재원) ORCID logo https://orcid.org/0000-0002-4585-1488
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