PROGNOSTIC IMPORTANCE OF HYPONATREMIA IN ACUTE STELEVATION MYOCARDIAL INFARCTION

Abstract

Background: Hyponatremia has been shown to be a predictor of cardiovascular mortality among patients with heart failure. In fact, the neurohormonal activation that accompanies acute myocardial infarction is similar to that which accompanies heart failure. Aims And Objectives : To nd out the prognostic importance of hyponatremia in acute ST elevation myocardial infarction. Material And Methods: 100 consecutive patients presenting with acute ST-elevation myocardial infarction admitted to N.R.I Medical college and General hospital from March 2019 to March 2020 were studied. Qualifying patients underwent detailed history and clinical examination. Plasma sodium concentrations were obtained on admission and at 24, 48 and 72 hours thereafter. The primary end point was all cause mortality within 30 days following myocardial infarction. Results: In our study, substantial proportion of patients who presented with acute ST elevation myocardial infarction were hyponatremic on admission or developed hyponatremia shortly after admission. The odd's ratio for 30-day mortality was found to be high in the hyponatremic groups compared to normal group. We also found a signicant linear relationship between severity of hyponatremia and mortality. Multivariate analysis was performed which identied hyponatremia on admission or early development of hyponatremia as a signicant independent predictor of 30 day mortality. Conclusion: In our study we concluded that hyponatremia on admission or early development of hyponatremia in patients with acute ST elevation myocardial infarction is an independent predictor of 30-day mortality. Plasma sodium levels may serve as a simple marker to identify patients at risk.