Prognostic importance of hyponatremia in acute st- elevation myocardial infarction

Abstract

BACKGROUND AND OBJECTIVE: Hyponatremia is the most common electrolyte disorder in clinical settings and in hospitalized patients, and is found to be the most important predisposing factor of cardiovascular mortality among patients with heart failure. The fact is that the neuro humoral activation is similar to both acute myocardial infarction and heart failure. So our aim is to investigate the prognostic importance of hyponatremia in acute ST elevation MI and to establish its usefulness in predicting short term survival. MATERIAL: From June 2013 to June 2014, around 100 patients who presented with acute ST-elevation MI admitted in ICCU of Coimbatore Medical College Hospital, Coimbatore was studied. METHOD: 100 consecutive patients who were selected underwent detailed history and clinical examination. Their Plasma sodium concentrations were obtained on admission and at 24, 48 and 72 hours after that. The end point was to find the cause which caused mortality within 30 days following myocardial infarction. RESULTS: The result of this study was found to be that, the proportion of patients who presented with acute ST elevation MI were hyponatremic at the time of admission or developed hyponatremia after admission. The 30 days mortality ratio was found to be high in hyponatremic group than normal group. There was also evidence that the severity of hyponatremia and mortality were having significant linear relationship. Multivariate analysis performed also showed that the significant independent predictor of 30 days mortality was identified as hyponatremia on admission or early development of hyponatremia. CONCLUSION: By this study we conclude that hyponatremia at the time of admission or shortly after that in patient with acute ST elevation MI is an independent predictor of 30days mortality. A simple marker to find patients at risk is Plasma Sodium Levels.