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The Effect of Hyponatremia on Short Term Prognosis in Patients with acute ST-Elevation Myocardial Infarction
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| Author:
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LAITH ALDABBAGH, SADIQ ALMUHANA, AMEER ZAINY, AHMED ALMUDAFFER, NAJAH HADI, MOHAMMED NOORI ALDUJAILY, GHASSAN AIED KAREEM
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| Abstract:
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The activation of the baroreceptor in acute STEMI, leads to activation of the sympathetic nervous system. this leads
to release of hormones like vasopressin (AVP) and also activation of rennin-angiotensin system. This neurohormonal
change is related to the severity of the myocardial damage. hyponatremia reflects these hormonal changes. So; serum
sodium level may be an indicator of the severity of ST elevation MI (STEMI). The aim of this study is to evaluate in
hospital prognosis of acute ST elevation myocardial infarction with hyponatremia. This prospective observational
study was included 116 patients presenting with acute ST-elevation myocardial infarction admitted to coronary care
unit (CCU) , in AL-Sader Medical City , Najaf , Iraq , during the period from ( April 2016 and February 2017 )
.Plasma sodium concentrations were taken on admission and at 24, 48 and 72 hours thereafter. The study subjects
divided into three groups, group I,include 33 patients with hyponatraemia on admission, group II include 31 patients
with hyponatraemia within 72 hours from admission, and control group include 52 patients with normal plasma
sodium level (135-145 mmol/L).Study group is collectively of group I and group II (hyponatraemicpatients on
admission and hyponatraemic patients within 72 hours), then compared with group III (control group "
normonatremicpatient).In this study of 116 patients who presented with acute ST-elevation myocardial infarction
(STEMI), hyponatremia was diagnosed in 33 patients (28.4%) at the time of admission , 31 patients (26.7%) within
72hours of admission (early developed hyponatremia) and 52 patients (44.9%) with normal serum sodium levelthe
heart failure rate was statistically significant in the patients with hyponatremia (study groups ) than in patient with
normonatremia (control group ) p -value < 0.001 , and statistically significant in sever hyponatremia p -value < 0.001 .
The mortality rate was significantly higher in the patients with hyponatremia (study groups) than in patient with
normonatremia (control group) p -value<0.001, and significantly higher in sever hyponatremia p –value <0.001.
Hyponatremia in patients with acute ST-elevation myocardial infarction, is strongly associated with sever LV
dysfunction and more mortality rate.
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| Keyword:
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STEMI , Hyponatremia, heart failure, MI.
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2018.10.04.022
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| Download:
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