Author + information
- Sem Briongos-Figuero,
- Sara Fernandez-Santos,
- Teresa de la Cal,
- Asunción Camino,
- Manuel Jiménez Mena and
- Jose Zamorano Gomez
Patients admitted for acute coronary syndrome (ACS) are frequently affected by electrolyte disturbances usually motivated by diuretic administration. Blood hyperosmolarity development and its influence on prognosis has not yet been studied. The aim was to assess hydration status and determine the importance of blood hyperosmolarity at admission in the prognosis of patients after ACS.
Consecutive registry of patients admitted due to ACS in Acute Care Unit (ACU) of our hospital for 18 months. Retrospectively we extracted peak blood osmolarity value during hospitalization in these patients.
Of a total of 550 patients with ACS, third suffered ST-elevation ACS. The mean age of the sample was 65.7 years, 73% were men, 56.8% had hypertension, 45.4% dyslipidemia, 26% diabetes, 41% were smokers and 12.5% [[Unable to Display Character: ​]][[Unable to Display Character: ​]]of patients were diagnosed with previous kidney failure. Total population was divided into three strat according to peak osmolarity during hospitalization: patients with peak osmolarity <260 mM / l (0.2%), between 260–290 mM / l (94.8%) (normal range) and> 290 mM / l (5%). In-hospital mortality and all-cause and cardiovascular (CV) mortality after a mean follow-up of 24 ± 13 months, were significantly higher in patients with peak osmolarity> 290 mM / l (p <0.001 for difference in Kaplan-Meier survival). In an univariate analysis it was strongly associated with diuretic use and development of renal failure. After adjusting for potential confounders (age, sex, other cardiovascular risk factors, history of renal insufficiency, renal failure development during ACU hospitalization, diuretic therapy or need for renal replacement therapy), blood hyperosmolarity during hospitalization (> 290mm / l) remained an independent predictor of all-cause, CV and in-hospital mortality (p <0.005 the three comparisons).
Hyperosmolarity development, is a strong predictor of in-hospital mortality and remains in independent predictor of all-cause and CV mortality after two years of an ACS. We must pay more attention of excessive water loss and be more cautious with diuretic therapy.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: The Blood Tells a Story: Coeptin, Fatty Acid Binding Protein, NT-Pro BNP and More
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1259-213
- 2013 American College of Cardiology Foundation