The Role of Race on Mortality in Hyponatremic Patients Admitted for Heart Failure: Not all are Created Equal

Abstract

Background Hyponatremia is a well-established poor prognostic marker in patients with heart failure (HF). Whether the mortality risk is comparable among different races of HF patients with hyponatremia is unknown. Hypothesis Mortality risk among hyponatremic patients with heart failure differ based on race. Methods Consecutive patients admitted with acute HF and an admission sodium level Results We included 4,343 patients, from which 1,356 identified as Caucasian (31%), 1,248 as AA (29%), 780 as Hispanic (18%) and 959 as other (22%). During a median follow-up of 23 months, a total of 2,384 patients died: 678 were AA, 820 were Caucasian, 298 were Hispanic and 588 were other. As shown in table 1 , Hispanics had the highest rates of HTN, DM, HLD, CKD, prior MI, and use of ACEI/ARB, beta blockers and ICDs. Caucasians had the highest rates of AF, CAD and COPD. There was no difference in 30-day readmission proportions among groups ( Table 1 ). After adjusting for all variables in Table 1 except for sodium levels, Hispanic patients had a 45% less risk of death as compared to AA (HR .55, CI .48-.64, p Conclusion Hispanic patients admitted for HF and who were hyponatremic on admission had independent lower risk of mortality compared to other races.