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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.
Austin Authors: 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
Affiliation: Freemasons Centre for Men's Health and Wellness, South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, South Australia, Australia
University of Melbourne, Melbourne, VIC, Australia
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70210, Kuopio, Finland.. Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland..
Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC, Australia
Department of General Medicine, University Hospital Geelong, Barwon Health, Bellerine Street, Geelong, VIC, 3220, Australia
IMPACT-the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Barwon Health, Geelong, VIC, Australia
University Hospital Geelong, Geelong, VIC, Australia
Faculty of Medicine, Royal Brisbane and Women's Hospital, University of Queensland, Herston, Brisbane, QLD, Australia
Faculty of Health, School of Nursing and Midwifery, Deakin University, Burwood, VIC, Australia
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70210, Kuopio, Finland..
Issue Date: 2-Sep-2022 2022
Publication information: BMC Cardiovascular Disorders 2022-09-02; 22(1): 391
Abstract: Lower urinary sodium concentrations (UNa) 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 UNa predicted major adverse coronary events (MACE) and all-cause mortality over 28-33 years. 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 UNa 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. 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 UNa 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 UNa 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). UNa 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. UNa may represent an emerging long-term prognostic biomarker that warrants further investigation.
DOI: 10.1186/s12872-022-02830-3
PubMed URL: 36056320
Type: Journal Article
Subjects: Biomarker
Heart failure
Translational medical research
Appears in Collections:Journal articles

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