Abstract 9792: Persistent Hypochloremia is Associated With Adverse Prognosis in Patients With Heart Failure

Abstract

Introduction: Prognostic impact of persistent hypochloremia has been unclear in patients with heart failure (HF). Methods & Results: We recruited data of patients who were hospitalized for HF at least twice repetitively at our hospital from 2010 to 2021 (n = 309). Patients were divided into four groups based on the absence/presence of hypochloremia (< 98 mmoL/L) at discharge from 1st and 2nd hospitalization: Group A (patients without hypochloremia at 1st and 2nd hospitalization, n = 238), Group B (those with hypochloremia at 1st hospitalization and without hypochloremia at 2nd hospitalization, n = 25), Group C (those without hypochloremia at 1st hospitalization and with hypochloremia at 2nd hospitalization, n = 32), and Group D (those with hypochloremia at 1st and 2nd hospitalization, persistent hypochloremia, n = 14). We compared patients’ characteristics and prognosis after 2nd discharge. Group D showed highest age (Group D vs. Group A, B, and C; 75.5, 73.0, 63.0, and 74.5 years, respectively, P = 0.037) and highest prevalence of atrial fibrillation (92.9%, 46.6%, 44.0%, and 50.0%, P = 0.009) among the four groups. Levels of B-type natriuretic peptide were comparable among the four groups. In the Kaplan-Meier analysis, all-cause mortality and cardiac mortality were highest in the Group D compared to other groups (Figure, log-rank P < 0.001). The multivariable Cox proportional hazard analysis revealed that persistent hypochloremia was independently associated with all-cause mortality (hazard ratio 3.235, P < 0.001) and cardiac mortality (hazard ratio 3.069, P = 0.004). Conclusions: Persistent hypochloremia predicts poor prognosis in patients with HF.