Usefulness of hypochloremia at the time of discharge to predict prognosis in patients with chronic heart failure after hospitalization.
J Cardiol
; 2024 Aug 31.
Article
em En
| MEDLINE
| ID: mdl-39222710
ABSTRACT
BACKGROUND:
Hypochloremia has been suggested as a strong marker of mortality in hospitalized patients with heart failure (HF). This study aimed to clarify whether incorporating hypochloremia into pre-existing prognostic models improved the performance of the models.METHODS:
We tested the prognostic value of hypochloremia (<97â¯mEq/L) measured at discharge in hospitalized patients with HF registered in the REALITY-AHF and NARA-HF studies. The primary outcome was 1-year mortality after discharge.RESULTS:
Among 2496 patients with HF, 316 (12.6â¯%) had hypochloremia at the time of discharge, and 387 (15.5â¯%) deaths were observed within 1â¯year of discharge. The presence of hypochloremia was strongly associated with higher 1-year mortality compared to those without hypochloremia (log-rank pâ¯<â¯0.001), and this association remained even after adjustment for the Get With the Guideline-HF risk model (GWTG-HF), anemia, New York Heart Association (NYHA) classification, and log-brain natriuretic peptide (BNP) [hazard ratio (HR) 1.64; pâ¯<â¯0.001]. Furthermore, adding hypochloremia to the prediction model composed of GWTG-HFâ¯+â¯anemiaâ¯+â¯NYHA classâ¯+â¯log-BNP yielded a numerically larger area under the curve (0.740 vs 0.749; pâ¯=â¯0.059) and significant improvement in net reclassification (0.159, pâ¯=â¯0.010).CONCLUSIONS:
Incorporating the presence of hypochloremia at discharge into pre-existing risk prediction models provides incremental prognostic information for hospitalized patients with HF.
Texto completo:
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Base de dados:
MEDLINE
Idioma:
En
Revista:
J Cardiol
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Japão