FREQUENCY OF HYPONATREMIA AND ITS SHORT TERM CLINICAL OUTCOMES AFTER ACUTE ST ELEVATION MYOCARDIAL INFARCTION
Objective: To determine the frequency of hyponatremia and its short termclinicaloutcomes after acute ST-elevation myocardial infarction.
Methodology: This cross sectional study was conducted at Department ofCardiology, Lady Reading Hospital Peshawar from 1st November 2014 to 30thApril 2015. Patients of either gender aged between 18 to 60 years admitted withacute ST elevation myocardial infarction were included in the study. Serumsodium was measured in all patients at admission, 24 hrs, 48 hrs and 72 hrs postadmission to detect hyponatremia. All hyponatremic patients were followedduring their hospital stay for in hospital mortality, acute heart failure andcardiogenic shock. P value of less than 0.05 was taken as significant.
Results: The total numbers of patients were 159. Mean age was 51.8 ± 7.2(18–60) yrs. Males were 70.4 % (n=112). Mean serum sodium was 138 ±6.8mmol/L. Of the total 47.2% (75) were hypertensive. Diabetes was found in 28.3%(45) of study population. 37.1% (59) were smoker. Dyslipidemia was found in32.1% (51). 18.9% (30) patients were having obesity. Hyponatremia (serumsodium ≤135mmol/L) was present in 22% (n=35) patients. Hyponatremia wasequally common in male and female patients (21.4% vs 23.4%). Sub groupanalyses revealed a higher but statistically insignificant hyponatremia in patientswith anterior MI and of older age. Of 35 hyponatremic patients all were followedduring their hospital stay for in-hospital outcomes. In hospital mortality noted inthese patients was 48.6% (p=0.001). Acute heart failure was in 60% ofhyponatremic patients (p=0.001). Cardiogenic shock was in 54.3% of patients(p= 0.001).
Conclusions: Hyponatremia in hospitalized patients with acute ST elevationmyocardial infarction is relatively common and is associated with higher inhospitaland early post-discharge mortality.
Key Words: Hyponatremia, ST elevation myocardial infarction, In-hospitalmortality, Acute heart failure, Cardiogenic shock.