Table1_Association between hyponatremia and adverse clinical outcomes of heart failure: current evidence based on a systematic review and meta-analysis.xlsx

BackgroundHeart failure (HF) is a global health challenge. The perturbations in fluid and electrolyte equilibrium, particularly the compromised sodium balance associated with HF lead to high mortality rates. Hence, elucidating the correlation between serum sodium levels and the prognosis of HF is of paramount importance. This study aimed to conduct a comprehensive meta-analysis to thoroughly investigate the interplay between hyponatremia and the prognostic outlook of individuals with HF.MethodsA comprehensive search of bibliographic databases including PubMed, Embase, and the Cochrane Central Register of Controlled Trials was conducted to identify relevant observational studies examining the association between hyponatremia and prognosis of HF. Data extraction, synthesis, and assessment of risk of bias were conducted. Meta-analytic methods, sensitivity analyses, and heterogeneity test were employed as appropriate to synthesize the data.ResultsA total of 43,316 patients with HF were included spanning 25 selected studies. The pooled data revealed a notable association between hyponatremia and elevated risks across short and long-term mortality of HF. Specifically, hyponatremia was found to significantly increase the likelihood of all-cause mortality (Hazard ratio [HR] = 1.94, 95% confidence interval [CI]: 1.78–2.12); 1-year mortality (HR = 1.67, 95%CI: 1.46–1.90); 30-day mortality (HR = 2.03, 95%CI: 1.73–2.25); cardiac mortality (HR = 2.11, 95%CI: 1.81–2.46); and in-hospital mortality (HR = 1.64, 95%CI: 1.15–2.34).ConclusionOur meta-analysis emphasizes the significant impact of hyponatremia on mortality in the HF patient population, highlighting the critical importance of maintaining stable serum sodium levels in HF management.

背景心力衰竭（HF）是全球性的健康挑战。体液与电解质平衡的紊乱，尤其是与HF相关联的钠平衡受损，导致高死亡率。因此，阐明血清钠水平与HF预后之间的相关性至关重要。本研究旨在进行一项全面的荟萃分析，深入探究低钠血症与HF患者预后之间的相互作用。方法对包括PubMed、Embase和Cochrane中央对照试验注册库在内的文献数据库进行了全面检索，以识别相关观察性研究，探讨低钠血症与HF预后的关联。进行了数据提取、综合分析和偏倚风险评估。根据需要采用了荟萃分析方法、敏感性分析和异质性检验以综合数据。结果共纳入43,316名HF患者，涉及25项选定研究。汇总数据揭示了低钠血症与HF短期和长期死亡率风险显著增加之间的关联。具体而言，低钠血症被发现显著增加了全因死亡率（危险比 [HR] = 1.94，95%置信区间 [CI]：1.78–2.12）；1年死亡率（HR = 1.67，95%CI：1.46–1.90）；30天死亡率（HR = 2.03，95%CI：1.73–2.25）；心血管死亡率（HR = 2.11，95%CI：1.81–2.46）；以及院内死亡率（HR = 1.64，95%CI：1.15–2.34）。结论我们的荟萃分析强调了低钠血症对HF患者群体死亡率的重要影响，凸显了在HF管理中维持稳定的血清钠水平的关键作用。