Prognostic value of hypochloremia on mortality in patients with heart failure: a systematic review and meta-analysis.
J Cardiovasc Med (Hagerstown)
; 25(7): 499-510, 2024 Jul 01.
Article
en En
| MEDLINE
| ID: mdl-38809244
ABSTRACT
AIMS:
Electrolyte imbalances are common in patients with heart failure. Several studies have shown that a low serum chloride level is associated with adverse outcomes in hospitalized patients with acute heart failure and in outpatients with chronic heart failure. We performed a systematic review and meta-analysis to assess the association of hypochloremia with all-cause mortality in patients with heart failure.METHODS:
Data search was conducted from inception through 1 February 2023, using the following MeSH terms ('chloride' OR 'hypochloremia') AND 'heart failure'. Studies evaluating the association between serum chloride and all-cause mortality in patients with heart failure were included. The predefined primary outcome was all-cause mortality. Pooled hazard ratios and 95% confidence intervals (CIs) were used as effect estimates and calculated with a random-effects model; fixed-effects model and leave-one-out sensitivity analyses were also performed.RESULTS:
A total of 15 studies, involving 25â848 patients, were included. The prevalence of hypochloremia ranged from 8.6 to 31.5%. Follow-up time ranged from 6 to 67âmonths. Hypochloremia as a categorical variable was associated with an increased risk of all-cause mortality [hazard ratio 1.56; 95% confidence interval (CI) 1.38-1.75; P â<â0.001]. As a continuous variable, serum chloride was associated with all-cause mortality (hazard ratio per mmol/l decrease in serum chloride 1.06; 95% CI 1.05-1.07; P â<â0.001). Results were confirmed by using several sensitivity analyses.CONCLUSION:
Hypochloremia exhibits a significant prognostic value in patients with heart failure. Serum chloride can be used as an effective tool for risk stratifying in patients with heart failure.
Texto completo:
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Base de datos:
MEDLINE
Asunto principal:
Cloruros
/
Insuficiencia Cardíaca
Idioma:
En
Revista:
J Cardiovasc Med (Hagerstown)
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
Año:
2024
Tipo del documento:
Article