Title: Hyponatremia and in Hospital Mortality in Acute St Elevation Myocardial Infarction
Authors: Dr M. Ajeeth Fera, Dr S. Balasubramaniyan, Dr N. Paari
DOI: https://dx.doi.org/10.18535/jmscr/v5i10.142
Abstract
The present study is done to determine the prevalence and prognostic implications of hyponatremia in the setting of acute ST-elevation myocardial infarction. The study sample consists of 50 patients presenting with acute ST-elevation myocardial infarction. Plasma sodium concentrations were obtained on admission and at 24, 48, and 72 hours thereafter. Patients with ckd stage 3, 4 and 5, CCF patients on diuretics, previous history of head injury and stroke, known hypothyroidism patients and nephrotic syndrome are excluded in this study. Hyponatremia, defined as a plasma sodium level <135 mmol/L (<135 mEq/L), is present in 20 patients within first 72 hours of hospitalization where 25% patients died. In rest of 30 patients, only 3.3% of patients died. Hyponatremia on admission or early development of hyponatremia in patients with acute ST-elevation myocardial infarction is an independent predictor of mortality and prognosis.
Keywords: hyponatremia, myocardial infarction.
References
- Elliott M. Antman, Joseph Loscalzo. ST-Segment Elevation Myocardial In Kasper, Fauci, Hauser, Longo, loscalzo and Jameson editors. Harrison’s Principles of Internal Medicine vol-2.19th edn. Newyork: McGraw Hill; 2015.p. 1602.
- Gazino JM. Global burden of cardiovascular disease. In: Zipes, Libby, Bonow, Braunwald editors. Brauwnwalds Heart disease, a text book of cardiovascular medicine. 8th edn. Philadelphia: Elsevier Saunders; 2008. Part 1 p.1-13
- Mcalpine HM, Morton JJ, Leckie B, Rumley A, Gillen G, Dargie HJ. Neuroendocrine activation after acute myocardial infarction. Br Heart J 1988;60:117-124
- Rowe JW, Shelton RL, Helderman JH. Influence of the emetic reflex on vasopressin release in man. Kidney Int. 1979; 16:729-735.
- Schaer GL, Covit AB, Laragh JH, Cody RJ. Association of hyponatremia with increased renin activity in chronic congestive heart failure: impact of diuretic therapy. Am J Cardiol. 1983; 51:1635-1638.
- Schaller MD, Nussberger J, Feihl F. Clinical and hemodynamic correlates of elevated plasma arginine vasopressin after acute myocardial infarction. Am J Cardiol 1987; 60:1178-1180.
- Schrier RW, Berl T, Anderson RJ. Osmotic and nonosmotic control of vasopressin release. Am J Physiol 1979; 236:321-332.
- Kumar S, Berl T. Sodium. Lancet 1998; 352:220-228.
- Cohn JN, Levine TB, Olivari MT. plasma nor epinephrine as a guide to prognosis in patients with chronic congestive heart failure. N Engl J Med 1984; 311:819-823.
- Dzau VJ, Colucci WS, Hollenberg NK, Williams GH. Relation of rennin angiotension aldosterone system to clinical state in congestive heart failure. Circulation 1981; 63:645-651.
- 2006 Apr 10; 166(7):781-6. Hyponatremia and long-term mortality in survivors of acute ST-elevation myocardial infarction. Goldberg A1, Hammerman H, Petcherski S, Nassar M, Zdorovyak A, Yalonetsky S, Kapeliovich M, Agmon Y, Beyar R, Markiewicz W, Aronson D.Department of Cardiology, Rambam Medical Center and Rappaport Medical School, Haifa, Israel.