Heart failure & cardiomyopathiesCohort study
Prognostic and exploratory neurohormonal correlates of hypochloraemia in heart failure: a multicentre cohort study
- multicentre prospective cohort study
Authors' conclusion
Hypochloraemia identified patients with heart failure at substantially increased cardiovascular risk independent of established prognostic markers. Exploratory analyses suggested a potential association between circulating UCN2 and chloride homeostasis that warrants mechanistic investigation.
Study context
- Population
- Patients discharged after hospitalisation for acute or worsening heart failure with available serum chloride measurementspatients included, exploratory UCN2 analyses in a predefined subset of 499 patients · UCN2 exploratory subset 499
- Participants
- 3,941 patients
- Exposure
- Associations between chloride status and 2-year outcomes
Main finding
All-cause mortality · 2-year
Adjusted hazard ratio
2.09
95% CI 1.64–2.67
P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
Cardiovascular mortality · 2-year
| Comparison | adjusted HR (95% CI) | P value | |
|---|---|---|---|
| hypochloraemia · comparator not stated · multivariable adjustment | 2.29 (1.64–3.20) | P < 0.001 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Heart failure rehospitalisation · 2-year
| Comparison | adjusted HR (95% CI) | P value | |
|---|---|---|---|
| hypochloraemia · comparator not stated · multivariable adjustment | 1.30 (1.02–1.67) | P = 0.04 | |
| 0.512Adjusted hazard ratio (log scale) |
Composite outcome · 2-year
| Comparison | adjusted HR (95% CI) | P value | |
|---|---|---|---|
| hypochloraemia · comparator not stated · multivariable adjustment | 1.46 (1.20–1.78) | P < 0.001 | |
| 0.512Adjusted hazard ratio (log scale) |
Competing risk analysis of mortality
- Excess mortality risk associated with hypochloraemia was predominantly cardiovascular
All-cause mortality in models including both serum chloride and sodium
- Chloride remained independently associated with all-cause mortality whereas sodium did not
Circulating UCN2 concentrations vs serum chloride levels (exploratory)
- B
- −0.37
- 95% CI
- −0.72 to −0.02
- p
- P = 0.04
- modest inverse association
- adjusted for sodium, renal function, nutritional status and clinical severity
- exploratory
Original publication
Summarised from the published abstract; every number is checked against it