低钠血症对行经皮冠状动脉介入治疗的急性冠脉综合征患者预后的影响

目的探究低钠血症对行经皮冠状动脉介入治疗(PCI)的急性冠脉综合征(ACS)患者预后的影响。方法纳入行PCI的ACS患者2162例,依据是否合并低钠血症(血清钠离子浓度<135mmol/L)分为低钠血症组(177例)和血钠正常组(1985例)。比较两组患者的临床资料、术后1年随访期间全因死亡和主要不良心血管事件的发生率。采用Cox回归模型分析低钠血症对行PCI的ACS患者预后的影响。结果低钠血症组既往有高血压病史、吸烟史、PCI史、术后使用血管紧张素转化酶抑制剂(ACEI)/血管紧张素Ⅱ受体拮抗剂(ARB)及术后1年随访期间全因死亡、心源性死亡患者比例、年龄、空腹血糖、总胆固醇、氨基末端脑钠肽前体(NT-proBNP)、入院时心率及GRACE评分均高于血钠正常组,白蛋白和左心室射血分数均低于血钠正常组(P<0.05)。Kaplan-Meier曲线分析结果显示,低钠血症组患者累积生存率低于血钠正常组(P<0.05)。单因素Cox分析结果显示,低钠血症与行PCI的ACS患者的全因死亡和心源性死亡独立相关(P<0.05)。经多因素校正后,低钠血症仍与其心源性死亡独立相关(P

The effect of hyponatremia on prognosis of patients with acute coronary syndrome undergoing percutaneous coronary intervention

Objective To explore the effect of hyponatremia on prognosis of patients with acute coronary syndrome(ACS)undergoning percutaneous coronary intervention(PCI).Methods A total of 2 162 patients with ACS undergoing PCI were divided into hyponatremia group(177 cases)and normal serum sodium group(1985 cases)according to combined with hyponatremia or not(serum sodium ion concentration<135 mmol/L).Clinical data,incidence rates of all-cause death and major cardiovascular adverse events during follow-up 1 year after PCI were compared between the two groups.Cox regression model was used to analyze the effect of hyponatremia on the prognosis of patients with ACS undergoing PCI.Results Rates of patients with hypertension history,smoking history,PCI history,using angiotensinconverting enzyme inhibitor(ACEI)/angiotensin U receptor antagonist(ARB)after PCI,all-cause death and cardiogenic death during follow-up 1 year after PCI,age,fasting blood glucose,total cholesterol,amino terminal pro-brain natriuretic peptide(NT-proBNP),heart rate at admission and GRACE score in hyponatremia group were higher than those in normal serum sodium group,albumin and left ventricular ejection fraction were lower than those in normal serum sodium group(P<0.05).Results of Kaplan-Meier curve analysis showed that cumulative survival rate of patients in hyponatremia group was lower than that in normal serum sodium group(P<0.05).Results of univariate Cox analysis showed that hyponatremia was independently correlated with all-cause death and cardiogenic death in patients with ACS undergoing PCI(P<0.05).After adjusting multi-factors,hyponatremia was still independently correlated with cardiogenic death(P<0.05).Conclusion Hyponatremia has predictive value for all-cause death and cardiogenic death in patients with ACS undergoing PCI 1 year after PCI,and hyponatremia is an independent predictor of cardiogenic death.