Baseline demographics in the overall population and hyponatremia stratification cohorts
| Characteristic . | Study population (N = 911, %) . | Normal sodium (N = 507, 56%) . | Mild hyponatremia (N = 268, 29%) . | Moderate hyponatremia (N = 105, 12%) . | Severe hyponatremia (N = 31, 3%) . | P value for trend . |
|---|---|---|---|---|---|---|
| Age, years (mean ± SD) | 67 ± 12 | 67 ± 11 | 66 ± 13 | 67 ± 12 | 65 ± 14 | 0.457 |
| Male gender | 715 (78) | 396 (78) | 213 (79) | 85 (81) | 21 (68) | 0.441 |
| Ischemic cardiomyopathy | 656 (72) | 367 (72) | 189 (71) | 77 (73) | 23 (74) | 0.920 |
| LVEF, % (mean ± SD) | 24 ± 8 | 24 ± 8 | 23 ± 9 | 23 ± 9 | 21 ± 9 | 0.012 |
| Prior coronary revascularization | 465 (51) | 257 (51) | 140 (52) | 16 (52) | 15 (52) | 0.964 |
| Heart failure NYHA class II-III | 281 (31) | 150 (30) | 82 (32) | 31 (30) | 14 (45) | 0.034 |
| Prior atrial tachyarrhythmias | 267 (29) | 146 (29) | 71 (26) | 42 (40) | 8 (26) | 0.070 |
| Diabetes mellitus | 292 (32) | 150 (30) | 91 (34) | 38 (36) | 13 (42) | 0.523 |
| Primary indication for ICD implantation | 556 (61) | 322 (62) | 169 (63) | 47 (45) | 18 (58) | 0.004 |
| Single chamber pacemaker ICD | 215 (24) | 116 (23) | 61 (23) | 33 (31) | 5 (16) | 0.019 |
| Dual chamber pacemaker ICD | 431 (47) | 240 (47) | 132 (49) | 45 (43) | 14 (45) | 0.770 |
| CRT-D | 265 (29) | 151 (30) | 75 (28) | 27 (26) | 12 (39) | 0.005 |
| Medication therapy | ||||||
| Beta blockers | 750 (82) | 418 (82) | 225 (84) | 83 (79) | 24 (77) | 0.691 |
| Carvedilol, mg (mean daily dose ± SD) | 26 ± 18 | 25 ± 20 | 24 ± 20 | 22 ± 16 | 20 ± 14 | 0.123 |
| Metoprolol, mg (mean daily dose ± SD) | 132 ± 34 | 146 ± 26 | 146 ± 26 | 132 ± 34 | 118 ± 39 | 0.164 |
| Aspirin | 466 (51) | 264 (52) | 143 (53) | 50 (48) | 9 (29) | 0.063 |
| Statins | 491 (54) | 295 (58) | 130 (49) | 52 (50) | 14 (45) | 0.034 |
| Warfarin | 360 (40) | 196 (39) | 110 (41) | 43 (41) | 11 (35) | 0.869 |
| ACE inhibitors | 473 (52) | 246 (49) | 152 (57) | 63 (60) | 12 (39) | 0.021 |
| Aldosterone receptor antagonists | 207 (23) | 95 (19) | 69 (26) | 29 (28) | 14 (45) | 0.001 |
| ARB | 162 (18) | 97 (19) | 44 (16) | 17 (16) | 4 (13) | 0.646 |
| Digoxin | 323 (35) | 172 (34) | 95 (35) | 46 (44) | 10 (32) | 0.277 |
| Amiodarone | 147 (16) | 81 (16) | 40 (15) | 19 (18) | 7 (23) | 0.671 |
| Furosemide | 543 (60) | 296 (58) | 156 (58) | 69 (66) | 22 (71) | 0.281 |
| Furosemide, mg (mean daily dose ± SD) | 55 ± 44 | 53 ± 44 | 53 ± 40 | 56 ± 41 | 82 ± 62 | 0.039 |
| Laboratory result (mean ± SD) | ||||||
| Sodium, mmol/L | 137 ± 3 | 139 ± 2 | 135 ± 0.8 | 132 ± 0.7 | 128 ± 2 | <0.001 |
| Potassium, mmol/L | 4.2 ± 0.5 | 4.1 ± 0.4 | 4.2 ± 0.4 | 4.2 ± 0.5 | 4.2 ± 0.5 | 0.431 |
| BUN, mg/dL | 27 ± 16 | 25 ± 14 | 27 ± 16 | 31 ± 20 | 44 ± 26 | <0.001 |
| Creatinine, mg/dL | 1.4 ± 1.1 | 1.3 ± 0.9 | 1.3 ± 0.9 | 1.5 ± 1.4 | 2.1 ± 1.9 | 0.003 |
| Hemoglobin, g/dL | 12.5 ± 1.9 | 12.6 ± 1.9 | 12.4 ± 1.9 | 12.3 ± 2.3 | 12.1 ± 2.1 | 0.325 |
| WBC × 103/μL | 8.3 ± 2.7 | 8.0 ± 2.7 | 8.6 ± 2.5 | 8.4 ± 2.5 | 9.4 ± 3.8 | 0.001 |
| RDW, % | 14.4 ± 1.7 | 14.3 ± 1.6 | 14.2 ± 1.9 | 14.7 ± 1.7 | 15.2 ± 2.0 | 0.002 |
| Follow-up duration (days) | 775 ± 750 | 767 ± 719 | 821 ± 806 | 739 ± 728 | 706 ± 697 | 0.039 |
| Characteristic . | Study population (N = 911, %) . | Normal sodium (N = 507, 56%) . | Mild hyponatremia (N = 268, 29%) . | Moderate hyponatremia (N = 105, 12%) . | Severe hyponatremia (N = 31, 3%) . | P value for trend . |
|---|---|---|---|---|---|---|
| Age, years (mean ± SD) | 67 ± 12 | 67 ± 11 | 66 ± 13 | 67 ± 12 | 65 ± 14 | 0.457 |
| Male gender | 715 (78) | 396 (78) | 213 (79) | 85 (81) | 21 (68) | 0.441 |
| Ischemic cardiomyopathy | 656 (72) | 367 (72) | 189 (71) | 77 (73) | 23 (74) | 0.920 |
| LVEF, % (mean ± SD) | 24 ± 8 | 24 ± 8 | 23 ± 9 | 23 ± 9 | 21 ± 9 | 0.012 |
| Prior coronary revascularization | 465 (51) | 257 (51) | 140 (52) | 16 (52) | 15 (52) | 0.964 |
| Heart failure NYHA class II-III | 281 (31) | 150 (30) | 82 (32) | 31 (30) | 14 (45) | 0.034 |
| Prior atrial tachyarrhythmias | 267 (29) | 146 (29) | 71 (26) | 42 (40) | 8 (26) | 0.070 |
| Diabetes mellitus | 292 (32) | 150 (30) | 91 (34) | 38 (36) | 13 (42) | 0.523 |
| Primary indication for ICD implantation | 556 (61) | 322 (62) | 169 (63) | 47 (45) | 18 (58) | 0.004 |
| Single chamber pacemaker ICD | 215 (24) | 116 (23) | 61 (23) | 33 (31) | 5 (16) | 0.019 |
| Dual chamber pacemaker ICD | 431 (47) | 240 (47) | 132 (49) | 45 (43) | 14 (45) | 0.770 |
| CRT-D | 265 (29) | 151 (30) | 75 (28) | 27 (26) | 12 (39) | 0.005 |
| Medication therapy | ||||||
| Beta blockers | 750 (82) | 418 (82) | 225 (84) | 83 (79) | 24 (77) | 0.691 |
| Carvedilol, mg (mean daily dose ± SD) | 26 ± 18 | 25 ± 20 | 24 ± 20 | 22 ± 16 | 20 ± 14 | 0.123 |
| Metoprolol, mg (mean daily dose ± SD) | 132 ± 34 | 146 ± 26 | 146 ± 26 | 132 ± 34 | 118 ± 39 | 0.164 |
| Aspirin | 466 (51) | 264 (52) | 143 (53) | 50 (48) | 9 (29) | 0.063 |
| Statins | 491 (54) | 295 (58) | 130 (49) | 52 (50) | 14 (45) | 0.034 |
| Warfarin | 360 (40) | 196 (39) | 110 (41) | 43 (41) | 11 (35) | 0.869 |
| ACE inhibitors | 473 (52) | 246 (49) | 152 (57) | 63 (60) | 12 (39) | 0.021 |
| Aldosterone receptor antagonists | 207 (23) | 95 (19) | 69 (26) | 29 (28) | 14 (45) | 0.001 |
| ARB | 162 (18) | 97 (19) | 44 (16) | 17 (16) | 4 (13) | 0.646 |
| Digoxin | 323 (35) | 172 (34) | 95 (35) | 46 (44) | 10 (32) | 0.277 |
| Amiodarone | 147 (16) | 81 (16) | 40 (15) | 19 (18) | 7 (23) | 0.671 |
| Furosemide | 543 (60) | 296 (58) | 156 (58) | 69 (66) | 22 (71) | 0.281 |
| Furosemide, mg (mean daily dose ± SD) | 55 ± 44 | 53 ± 44 | 53 ± 40 | 56 ± 41 | 82 ± 62 | 0.039 |
| Laboratory result (mean ± SD) | ||||||
| Sodium, mmol/L | 137 ± 3 | 139 ± 2 | 135 ± 0.8 | 132 ± 0.7 | 128 ± 2 | <0.001 |
| Potassium, mmol/L | 4.2 ± 0.5 | 4.1 ± 0.4 | 4.2 ± 0.4 | 4.2 ± 0.5 | 4.2 ± 0.5 | 0.431 |
| BUN, mg/dL | 27 ± 16 | 25 ± 14 | 27 ± 16 | 31 ± 20 | 44 ± 26 | <0.001 |
| Creatinine, mg/dL | 1.4 ± 1.1 | 1.3 ± 0.9 | 1.3 ± 0.9 | 1.5 ± 1.4 | 2.1 ± 1.9 | 0.003 |
| Hemoglobin, g/dL | 12.5 ± 1.9 | 12.6 ± 1.9 | 12.4 ± 1.9 | 12.3 ± 2.3 | 12.1 ± 2.1 | 0.325 |
| WBC × 103/μL | 8.3 ± 2.7 | 8.0 ± 2.7 | 8.6 ± 2.5 | 8.4 ± 2.5 | 9.4 ± 3.8 | 0.001 |
| RDW, % | 14.4 ± 1.7 | 14.3 ± 1.6 | 14.2 ± 1.9 | 14.7 ± 1.7 | 15.2 ± 2.0 | 0.002 |
| Follow-up duration (days) | 775 ± 750 | 767 ± 719 | 821 ± 806 | 739 ± 728 | 706 ± 697 | 0.039 |
SD, standard deviation; CM, cardiomyopathy; LVEF, left ventricular ejection fraction; NYHA, New York Heart Association; ESRD, end-stage renal disease; COPD, chronic obstructive pulmonary disease; ICD, implantable cardioverter defibrillator; ACE, angiotensin converting enzyme; ARB, angiotensin receptor blocker; CRT-D, cardiac-resynchronization therapy ICD; BUN, blood–urea nitrogen; WBC, white blood cell; RDW, red cell distribution width.
Baseline demographics in the overall population and hyponatremia stratification cohorts
| Characteristic . | Study population (N = 911, %) . | Normal sodium (N = 507, 56%) . | Mild hyponatremia (N = 268, 29%) . | Moderate hyponatremia (N = 105, 12%) . | Severe hyponatremia (N = 31, 3%) . | P value for trend . |
|---|---|---|---|---|---|---|
| Age, years (mean ± SD) | 67 ± 12 | 67 ± 11 | 66 ± 13 | 67 ± 12 | 65 ± 14 | 0.457 |
| Male gender | 715 (78) | 396 (78) | 213 (79) | 85 (81) | 21 (68) | 0.441 |
| Ischemic cardiomyopathy | 656 (72) | 367 (72) | 189 (71) | 77 (73) | 23 (74) | 0.920 |
| LVEF, % (mean ± SD) | 24 ± 8 | 24 ± 8 | 23 ± 9 | 23 ± 9 | 21 ± 9 | 0.012 |
| Prior coronary revascularization | 465 (51) | 257 (51) | 140 (52) | 16 (52) | 15 (52) | 0.964 |
| Heart failure NYHA class II-III | 281 (31) | 150 (30) | 82 (32) | 31 (30) | 14 (45) | 0.034 |
| Prior atrial tachyarrhythmias | 267 (29) | 146 (29) | 71 (26) | 42 (40) | 8 (26) | 0.070 |
| Diabetes mellitus | 292 (32) | 150 (30) | 91 (34) | 38 (36) | 13 (42) | 0.523 |
| Primary indication for ICD implantation | 556 (61) | 322 (62) | 169 (63) | 47 (45) | 18 (58) | 0.004 |
| Single chamber pacemaker ICD | 215 (24) | 116 (23) | 61 (23) | 33 (31) | 5 (16) | 0.019 |
| Dual chamber pacemaker ICD | 431 (47) | 240 (47) | 132 (49) | 45 (43) | 14 (45) | 0.770 |
| CRT-D | 265 (29) | 151 (30) | 75 (28) | 27 (26) | 12 (39) | 0.005 |
| Medication therapy | ||||||
| Beta blockers | 750 (82) | 418 (82) | 225 (84) | 83 (79) | 24 (77) | 0.691 |
| Carvedilol, mg (mean daily dose ± SD) | 26 ± 18 | 25 ± 20 | 24 ± 20 | 22 ± 16 | 20 ± 14 | 0.123 |
| Metoprolol, mg (mean daily dose ± SD) | 132 ± 34 | 146 ± 26 | 146 ± 26 | 132 ± 34 | 118 ± 39 | 0.164 |
| Aspirin | 466 (51) | 264 (52) | 143 (53) | 50 (48) | 9 (29) | 0.063 |
| Statins | 491 (54) | 295 (58) | 130 (49) | 52 (50) | 14 (45) | 0.034 |
| Warfarin | 360 (40) | 196 (39) | 110 (41) | 43 (41) | 11 (35) | 0.869 |
| ACE inhibitors | 473 (52) | 246 (49) | 152 (57) | 63 (60) | 12 (39) | 0.021 |
| Aldosterone receptor antagonists | 207 (23) | 95 (19) | 69 (26) | 29 (28) | 14 (45) | 0.001 |
| ARB | 162 (18) | 97 (19) | 44 (16) | 17 (16) | 4 (13) | 0.646 |
| Digoxin | 323 (35) | 172 (34) | 95 (35) | 46 (44) | 10 (32) | 0.277 |
| Amiodarone | 147 (16) | 81 (16) | 40 (15) | 19 (18) | 7 (23) | 0.671 |
| Furosemide | 543 (60) | 296 (58) | 156 (58) | 69 (66) | 22 (71) | 0.281 |
| Furosemide, mg (mean daily dose ± SD) | 55 ± 44 | 53 ± 44 | 53 ± 40 | 56 ± 41 | 82 ± 62 | 0.039 |
| Laboratory result (mean ± SD) | ||||||
| Sodium, mmol/L | 137 ± 3 | 139 ± 2 | 135 ± 0.8 | 132 ± 0.7 | 128 ± 2 | <0.001 |
| Potassium, mmol/L | 4.2 ± 0.5 | 4.1 ± 0.4 | 4.2 ± 0.4 | 4.2 ± 0.5 | 4.2 ± 0.5 | 0.431 |
| BUN, mg/dL | 27 ± 16 | 25 ± 14 | 27 ± 16 | 31 ± 20 | 44 ± 26 | <0.001 |
| Creatinine, mg/dL | 1.4 ± 1.1 | 1.3 ± 0.9 | 1.3 ± 0.9 | 1.5 ± 1.4 | 2.1 ± 1.9 | 0.003 |
| Hemoglobin, g/dL | 12.5 ± 1.9 | 12.6 ± 1.9 | 12.4 ± 1.9 | 12.3 ± 2.3 | 12.1 ± 2.1 | 0.325 |
| WBC × 103/μL | 8.3 ± 2.7 | 8.0 ± 2.7 | 8.6 ± 2.5 | 8.4 ± 2.5 | 9.4 ± 3.8 | 0.001 |
| RDW, % | 14.4 ± 1.7 | 14.3 ± 1.6 | 14.2 ± 1.9 | 14.7 ± 1.7 | 15.2 ± 2.0 | 0.002 |
| Follow-up duration (days) | 775 ± 750 | 767 ± 719 | 821 ± 806 | 739 ± 728 | 706 ± 697 | 0.039 |
| Characteristic . | Study population (N = 911, %) . | Normal sodium (N = 507, 56%) . | Mild hyponatremia (N = 268, 29%) . | Moderate hyponatremia (N = 105, 12%) . | Severe hyponatremia (N = 31, 3%) . | P value for trend . |
|---|---|---|---|---|---|---|
| Age, years (mean ± SD) | 67 ± 12 | 67 ± 11 | 66 ± 13 | 67 ± 12 | 65 ± 14 | 0.457 |
| Male gender | 715 (78) | 396 (78) | 213 (79) | 85 (81) | 21 (68) | 0.441 |
| Ischemic cardiomyopathy | 656 (72) | 367 (72) | 189 (71) | 77 (73) | 23 (74) | 0.920 |
| LVEF, % (mean ± SD) | 24 ± 8 | 24 ± 8 | 23 ± 9 | 23 ± 9 | 21 ± 9 | 0.012 |
| Prior coronary revascularization | 465 (51) | 257 (51) | 140 (52) | 16 (52) | 15 (52) | 0.964 |
| Heart failure NYHA class II-III | 281 (31) | 150 (30) | 82 (32) | 31 (30) | 14 (45) | 0.034 |
| Prior atrial tachyarrhythmias | 267 (29) | 146 (29) | 71 (26) | 42 (40) | 8 (26) | 0.070 |
| Diabetes mellitus | 292 (32) | 150 (30) | 91 (34) | 38 (36) | 13 (42) | 0.523 |
| Primary indication for ICD implantation | 556 (61) | 322 (62) | 169 (63) | 47 (45) | 18 (58) | 0.004 |
| Single chamber pacemaker ICD | 215 (24) | 116 (23) | 61 (23) | 33 (31) | 5 (16) | 0.019 |
| Dual chamber pacemaker ICD | 431 (47) | 240 (47) | 132 (49) | 45 (43) | 14 (45) | 0.770 |
| CRT-D | 265 (29) | 151 (30) | 75 (28) | 27 (26) | 12 (39) | 0.005 |
| Medication therapy | ||||||
| Beta blockers | 750 (82) | 418 (82) | 225 (84) | 83 (79) | 24 (77) | 0.691 |
| Carvedilol, mg (mean daily dose ± SD) | 26 ± 18 | 25 ± 20 | 24 ± 20 | 22 ± 16 | 20 ± 14 | 0.123 |
| Metoprolol, mg (mean daily dose ± SD) | 132 ± 34 | 146 ± 26 | 146 ± 26 | 132 ± 34 | 118 ± 39 | 0.164 |
| Aspirin | 466 (51) | 264 (52) | 143 (53) | 50 (48) | 9 (29) | 0.063 |
| Statins | 491 (54) | 295 (58) | 130 (49) | 52 (50) | 14 (45) | 0.034 |
| Warfarin | 360 (40) | 196 (39) | 110 (41) | 43 (41) | 11 (35) | 0.869 |
| ACE inhibitors | 473 (52) | 246 (49) | 152 (57) | 63 (60) | 12 (39) | 0.021 |
| Aldosterone receptor antagonists | 207 (23) | 95 (19) | 69 (26) | 29 (28) | 14 (45) | 0.001 |
| ARB | 162 (18) | 97 (19) | 44 (16) | 17 (16) | 4 (13) | 0.646 |
| Digoxin | 323 (35) | 172 (34) | 95 (35) | 46 (44) | 10 (32) | 0.277 |
| Amiodarone | 147 (16) | 81 (16) | 40 (15) | 19 (18) | 7 (23) | 0.671 |
| Furosemide | 543 (60) | 296 (58) | 156 (58) | 69 (66) | 22 (71) | 0.281 |
| Furosemide, mg (mean daily dose ± SD) | 55 ± 44 | 53 ± 44 | 53 ± 40 | 56 ± 41 | 82 ± 62 | 0.039 |
| Laboratory result (mean ± SD) | ||||||
| Sodium, mmol/L | 137 ± 3 | 139 ± 2 | 135 ± 0.8 | 132 ± 0.7 | 128 ± 2 | <0.001 |
| Potassium, mmol/L | 4.2 ± 0.5 | 4.1 ± 0.4 | 4.2 ± 0.4 | 4.2 ± 0.5 | 4.2 ± 0.5 | 0.431 |
| BUN, mg/dL | 27 ± 16 | 25 ± 14 | 27 ± 16 | 31 ± 20 | 44 ± 26 | <0.001 |
| Creatinine, mg/dL | 1.4 ± 1.1 | 1.3 ± 0.9 | 1.3 ± 0.9 | 1.5 ± 1.4 | 2.1 ± 1.9 | 0.003 |
| Hemoglobin, g/dL | 12.5 ± 1.9 | 12.6 ± 1.9 | 12.4 ± 1.9 | 12.3 ± 2.3 | 12.1 ± 2.1 | 0.325 |
| WBC × 103/μL | 8.3 ± 2.7 | 8.0 ± 2.7 | 8.6 ± 2.5 | 8.4 ± 2.5 | 9.4 ± 3.8 | 0.001 |
| RDW, % | 14.4 ± 1.7 | 14.3 ± 1.6 | 14.2 ± 1.9 | 14.7 ± 1.7 | 15.2 ± 2.0 | 0.002 |
| Follow-up duration (days) | 775 ± 750 | 767 ± 719 | 821 ± 806 | 739 ± 728 | 706 ± 697 | 0.039 |
SD, standard deviation; CM, cardiomyopathy; LVEF, left ventricular ejection fraction; NYHA, New York Heart Association; ESRD, end-stage renal disease; COPD, chronic obstructive pulmonary disease; ICD, implantable cardioverter defibrillator; ACE, angiotensin converting enzyme; ARB, angiotensin receptor blocker; CRT-D, cardiac-resynchronization therapy ICD; BUN, blood–urea nitrogen; WBC, white blood cell; RDW, red cell distribution width.
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