Hyponatraemia in acute heart failure is a marker of increased mortality but not when associated with hyperglycaemia.


Journal Article

UNLABELLED: Previous studies suggest that hyponatraemia is a marker of neurohormonal activation and increased mortality in patients with acute heart failure (AHF). Although diabetes is a common co-morbidity in heart failure, no prior study has considered the impact of serum glucose on this relationship. METHODS: Over four consecutive months we prospectively registered all patients admitted due to AHF. Sodium and glucose levels were determined immediately upon admission. Patients were followed through admission and for the next 6 months. Of 342 patients enrolled, complete data were available for 331 patients. RESULTS: Hyponatraemia (sodium <135 mmol/L) was detected in 22% of patients. However, 47% of patients with hyponatraemia had concomitant hyperglycaemia (glucose level >11 mmol/L). Hyponatraemia was associated with increased 6-month mortality (21 vs. 8%, p=0.002). This association was restricted to patients who had hyponatraemia without concomitant hyperglycaemia. The 6-month mortality of patients with and without hyponatraemia was 11% versus 10% (p=0.87) when hyperglycaemia was present versus 29% and 7% (p<0.001) when hyperglycaemia was absent. CONCLUSIONS: In this preliminary study, hyperglycaemia-associated hyponatraemia was present in a significant proportion of patients admitted with AHF. In patients with hyperglycaemia, hyponatraemia had no prognostic significance, whereas in patients without hyperglycaemia, hyponatraemia remained a powerful predictor of mortality. These results need confirmation in a larger study.

Full Text

Duke Authors

Cited Authors

  • Milo-Cotter, O; Cotter, G; Weatherley, BD; Adams, KF; Kaluski, E; Uriel, N; O'Connor, CM; Felker, GM

Published Date

  • February 2008

Published In

Volume / Issue

  • 10 / 2

Start / End Page

  • 196 - 200

PubMed ID

  • 18279774

Pubmed Central ID

  • 18279774

International Standard Serial Number (ISSN)

  • 1388-9842

Digital Object Identifier (DOI)

  • 10.1016/j.ejheart.2008.01.008


  • eng

Conference Location

  • England