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Urinary sodium concentration predicts time to major adverse coronary events and all-cause mortality in men with heart failure over a 28–33-year period: a prospective cohort study
BACKGROUND: Lower urinary sodium concentrations (U(Na)) may be a biomarker for poor prognosis in chronic heart failure (HF). However, no data exist to determine its prognostic association over the long-term. We investigated whether U(Na) predicted major adverse coronary events (MACE) and all-cause m...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9438140/ https://www.ncbi.nlm.nih.gov/pubmed/36056320 http://dx.doi.org/10.1186/s12872-022-02830-3 |
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author | Ganes, Anand Davis, Jessica A. Virtanen, Jyrki K. Voutilainen, Ari Tuomainen, Tomi-Pekka Atherton, John J. Amerena, John Driscoll, Andrea Hare, Dave L. Wittert, Gary Ruusunen, Anu Marx, Wolfgang Mohebbi, Mohammadreza O’Neil, Adrienne |
author_facet | Ganes, Anand Davis, Jessica A. Virtanen, Jyrki K. Voutilainen, Ari Tuomainen, Tomi-Pekka Atherton, John J. Amerena, John Driscoll, Andrea Hare, Dave L. Wittert, Gary Ruusunen, Anu Marx, Wolfgang Mohebbi, Mohammadreza O’Neil, Adrienne |
author_sort | Ganes, Anand |
collection | PubMed |
description | BACKGROUND: Lower urinary sodium concentrations (U(Na)) may be a biomarker for poor prognosis in chronic heart failure (HF). However, no data exist to determine its prognostic association over the long-term. We investigated whether U(Na) predicted major adverse coronary events (MACE) and all-cause mortality over 28–33 years. METHODS: One hundred and eighty men with chronic HF from the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) were included. Baseline data was collected between 1984 and 1989. MACE and all-cause outcomes were obtained using hospital linkage data (1984–2017) with a follow-up of 28–33 years. Cox proportional hazards models were generated using 24-h U(Na) tertiles at baseline (1 ≤ 173 mmol/day; 2 = 173-229 mmol/day; 3 = 230-491 mmol/day) as a predictor of time-to-MACE outcomes, adjusted for relevant covariates. RESULTS: Overall, 63% and 83% of participants (n = 114 and n = 150) had a MACE event (median 10 years) and all-cause mortality event (median 19 years), respectively. On multivariable Cox Model, relative to the lowest U(Na) tertile, no significant difference was noted in MACE outcome for individuals in tertiles 2 and 3 with events rates of 28% (HR:0.72; 95% CI: 0.46–1.12) and 21% (HR 0.79; 95% CI: 0.5–1.25) respectively.. Relative to the lowest U(Na) tertile, those in tertile 2 and 3 were 39% (HR: 0.61; 95% CIs: 0.41, 0.91) and 10% (HR: 0.90; 95% CIs: 0.62, 1.33) less likely to experience to experience all-cause mortality. The multivariable Cox model had acceptable prediction precision (Harrell's C concordance measure 0.72). CONCLUSION: U(Na) was a significant predictor of all-cause mortality but not MACE outcomes over 28–33 years with 173–229 mmol/day appearing to be the optimal level. U(Na) may represent an emerging long-term prognostic biomarker that warrants further investigation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-022-02830-3. |
format | Online Article Text |
id | pubmed-9438140 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-94381402022-09-03 Urinary sodium concentration predicts time to major adverse coronary events and all-cause mortality in men with heart failure over a 28–33-year period: a prospective cohort study Ganes, Anand Davis, Jessica A. Virtanen, Jyrki K. Voutilainen, Ari Tuomainen, Tomi-Pekka Atherton, John J. Amerena, John Driscoll, Andrea Hare, Dave L. Wittert, Gary Ruusunen, Anu Marx, Wolfgang Mohebbi, Mohammadreza O’Neil, Adrienne BMC Cardiovasc Disord Article BACKGROUND: Lower urinary sodium concentrations (U(Na)) may be a biomarker for poor prognosis in chronic heart failure (HF). However, no data exist to determine its prognostic association over the long-term. We investigated whether U(Na) predicted major adverse coronary events (MACE) and all-cause mortality over 28–33 years. METHODS: One hundred and eighty men with chronic HF from the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) were included. Baseline data was collected between 1984 and 1989. MACE and all-cause outcomes were obtained using hospital linkage data (1984–2017) with a follow-up of 28–33 years. Cox proportional hazards models were generated using 24-h U(Na) tertiles at baseline (1 ≤ 173 mmol/day; 2 = 173-229 mmol/day; 3 = 230-491 mmol/day) as a predictor of time-to-MACE outcomes, adjusted for relevant covariates. RESULTS: Overall, 63% and 83% of participants (n = 114 and n = 150) had a MACE event (median 10 years) and all-cause mortality event (median 19 years), respectively. On multivariable Cox Model, relative to the lowest U(Na) tertile, no significant difference was noted in MACE outcome for individuals in tertiles 2 and 3 with events rates of 28% (HR:0.72; 95% CI: 0.46–1.12) and 21% (HR 0.79; 95% CI: 0.5–1.25) respectively.. Relative to the lowest U(Na) tertile, those in tertile 2 and 3 were 39% (HR: 0.61; 95% CIs: 0.41, 0.91) and 10% (HR: 0.90; 95% CIs: 0.62, 1.33) less likely to experience to experience all-cause mortality. The multivariable Cox model had acceptable prediction precision (Harrell's C concordance measure 0.72). CONCLUSION: U(Na) was a significant predictor of all-cause mortality but not MACE outcomes over 28–33 years with 173–229 mmol/day appearing to be the optimal level. U(Na) may represent an emerging long-term prognostic biomarker that warrants further investigation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-022-02830-3. BioMed Central 2022-09-02 /pmc/articles/PMC9438140/ /pubmed/36056320 http://dx.doi.org/10.1186/s12872-022-02830-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Article Ganes, Anand Davis, Jessica A. Virtanen, Jyrki K. Voutilainen, Ari Tuomainen, Tomi-Pekka Atherton, John J. Amerena, John Driscoll, Andrea Hare, Dave L. Wittert, Gary Ruusunen, Anu Marx, Wolfgang Mohebbi, Mohammadreza O’Neil, Adrienne Urinary sodium concentration predicts time to major adverse coronary events and all-cause mortality in men with heart failure over a 28–33-year period: a prospective cohort study |
title | Urinary sodium concentration predicts time to major adverse coronary events and all-cause mortality in men with heart failure over a 28–33-year period: a prospective cohort study |
title_full | Urinary sodium concentration predicts time to major adverse coronary events and all-cause mortality in men with heart failure over a 28–33-year period: a prospective cohort study |
title_fullStr | Urinary sodium concentration predicts time to major adverse coronary events and all-cause mortality in men with heart failure over a 28–33-year period: a prospective cohort study |
title_full_unstemmed | Urinary sodium concentration predicts time to major adverse coronary events and all-cause mortality in men with heart failure over a 28–33-year period: a prospective cohort study |
title_short | Urinary sodium concentration predicts time to major adverse coronary events and all-cause mortality in men with heart failure over a 28–33-year period: a prospective cohort study |
title_sort | urinary sodium concentration predicts time to major adverse coronary events and all-cause mortality in men with heart failure over a 28–33-year period: a prospective cohort study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9438140/ https://www.ncbi.nlm.nih.gov/pubmed/36056320 http://dx.doi.org/10.1186/s12872-022-02830-3 |
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