Impact of Hyponatremia on Survival of Acute St-Elevation Myocardial Infarction Patients during 30 Days

objective Hyponatremia has been shown to be a predictor of cardiovascular mortality among patients with heart failure. Hyponatremia is intial insult for neurohormonal activation and left ventricular remodeling in acute myocardial infarction, both these factors are responsible with other factors for predicting short term survival in patient of acute myocardial infarctions. Hence we aimed to investigate the impact of hyponatremia in the setting of acute ST elevation MI and to determine its usefulness in predicting short term survival. Material and methods 100 consecutive patients presenting with acute ST-elevation myocardial infarction admitted to M. B. S. HOSPITAL, G. M. C. KOTA, from aug 2013 to dec 2014 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. Hyponatremia was correlated with various parameters like age, male sex, diabetes, anterior infacrtion, killip class, mean ejection fracrtion. 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. Corelation of hyponatremia was found highly significant with male sex (pvalue=0.012), diabetes (p value=0.04), killip class (p value=0.02), ejection fraction (p value=0.008), but no correlation was found with age, sex, smoking. We also found a significant linear relationship between severity of hyponatremia and mortality. Multivariate analysis was performed which identified hyponatremia on admission or early development of hyponatremia as a significant 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.