Impact of hypochloremia as a prognostic factor in patients with heart failure, a retrospective cohort study

some studies suggest that hypochloremia is a risk factor in the prognosis of heart failure (HF) in patients with recent decompensation. retrospective cohort study of patients discharged due to HF decompensation who began follow-up in a specialized clinic. Two groups are defined: patients with hypoch...

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Veröffentlicht in:Revista clínica espanõla (English edition) 2024-05, Vol.224 (5), p.259-266
Hauptverfasser: de Peralta García, P., Bolzoni, M., Yebra Yebra, M., Asenjo Martín, M., Arrondo Turrado, M., Domínguez Sepúlveda, M.A., Rueda Camino, J.A., Barba Martín, R.
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Sprache:eng
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Zusammenfassung:some studies suggest that hypochloremia is a risk factor in the prognosis of heart failure (HF) in patients with recent decompensation. retrospective cohort study of patients discharged due to HF decompensation who began follow-up in a specialized clinic. Two groups are defined: patients with hypochloremia (chloride < 98 mmol/L) and normochloremic patients (chloride > 98 mmol/L) in the initial assessment within the first month after discharge. The rate of intravenous diuretic rescue, emergency department visits, readmission for HF and cardiovascular (CV) death are compared using a Cox proportional hazards model. 165 patients were included (59% women, mean age 85 years), with 60 (36%) having hypochloremia. Both groups were comparable in terms of baseline characteristics, except for female sex, presence of peripheral artery disease, moderate-to-severe liver disease (more prevalent in the hypochloremia group), PROFUND index, and baseline furosemide dose (higher in patients with hypochloremia). The incidence of the primary event was higher in subjects with hypochloremia than in normochloremic subjects (HR: 1.59, 95% CI 0.97–2.62), mainly due to the need for intravenous diuretic rescue (HR: 1.86, 95% CI 1.07−3.24). hypochloremia following admission for HF decompensation is associated with a greater need for intravenous diuretic rescue therapy and probably worse overall prognosis across the spectrum of the disease, regardless of left ventricular ejection fraction (LVEF). Algunos estudios sugieren que la hipocloremia es un marcador de riesgo en el pronóstico de la insuficiencia cardíaca (IC) en pacientes con descompensación reciente. estudio de cohortes retrospectivo de pacientes dados de alta por descompensación de IC que inician seguimiento en consulta monográfica. Se definen dos grupos: pacientes con hipocloremia (cloro < 98 mmol/L) y pacientes normoclorémicos (cloro > 98 mmol/L) en la primera determinación dentro del primer mes tras el alta. Se compara la tasa de rescate diurético intravenoso, visita a urgencias, reingreso por IC y muerte de origen cardiovascular (CV), mediante un modelo de riesgos proporcionales de Cox. se incluyeron 165 pacientes (59% mujeres, edad media 85 años), 60 (36%) con hipocloremia. Ambos grupos eran comparables en cuanto a características basales, salvo sexo femenino, presencia de arteriopatía periférica, hepatopatía moderada-grave (más prevalentes en el grupo con hipocloremia), índice PROFUND y dosis basal de furosemida (más altos
ISSN:2254-8874
2254-8874
DOI:10.1016/j.rceng.2024.04.003