Impact of hypotonic hyponatremia on outcomes in patients undergoing transcatheter aortic valve replacement: a national inpatient sample
Abstract Background Transcatheter aortic valve replacement (TAVR) has emerged as a major therapeutic option for treating aortic stenosis. Hyponatremia is a common electrolyte disorder closely associated with adverse cardiovascular outcomes. However, large-scale studies investigating the impact of hy...
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BMC
2025-03-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-025-04564-4 |
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| author | Shizhe Fu Kairu Wang Xueping Ma Bo Shi Congyan Ye Rui Yan Ru Yan Shaobin Jia Guangzhi Cong Israel Gitangaza Abdul Rehman |
| author_facet | Shizhe Fu Kairu Wang Xueping Ma Bo Shi Congyan Ye Rui Yan Ru Yan Shaobin Jia Guangzhi Cong Israel Gitangaza Abdul Rehman |
| author_sort | Shizhe Fu |
| collection | DOAJ |
| description | Abstract Background Transcatheter aortic valve replacement (TAVR) has emerged as a major therapeutic option for treating aortic stenosis. Hyponatremia is a common electrolyte disorder closely associated with adverse cardiovascular outcomes. However, large-scale studies investigating the impact of hypotonic hyponatremia on outcomes among TAVR patients are lacking. Methods We queried patients who underwent TAVR with concomitant hypo-osmolar hyponatremia (defined as a serum sodium concentration < 135 mEq/L with a serum osmolality < 280 mOsm/kg) using the National Inpatient Sample (2016–2021). Multivariate regression analysis and 1:1 propensity score matching (PSM) were performed to assess the associations between hypo-osmolar hyponatremia and in-hospital mortality and major adverse events (including acute kidney injury [AKI], acute myocardial infarction [AMI], and cardiogenic shock [CS]). Furthermore, sensitivity analysis was performed to assess the robustness of the findings. Results Among the total weighted national estimate of 370,680 patients who underwent TAVR, 13,865 (3.7%) had concomitant hypo-osmolar hyponatremia. These patients had a significantly increased risk of in-hospital mortality (aOR: 1.37; 95% CI: 1.08–1.74) and a greater likelihood of developing AKI (aOR: 3.39; 95% CI: 3.07–3.74), AMI (aOR: 3.20; 95% CI: 2.77–3.70), and CS (aOR: 2.96; 95% CI: 2.52–3.47). After PSM and sensitivity analysis, these associations remained significant. Conclusion In TAVR patients, hypo-osmolar hyponatremia is associated with increased in-hospital mortality and adverse events, including AKI, AMI, and CS. |
| format | Article |
| id | doaj-art-e4e73c18f73a4c7487de63576b572ffd |
| institution | DOAJ |
| issn | 1471-2261 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj-art-e4e73c18f73a4c7487de63576b572ffd2025-08-20T02:56:08ZengBMCBMC Cardiovascular Disorders1471-22612025-03-0125111010.1186/s12872-025-04564-4Impact of hypotonic hyponatremia on outcomes in patients undergoing transcatheter aortic valve replacement: a national inpatient sampleShizhe Fu0Kairu Wang1Xueping Ma2Bo Shi3Congyan Ye4Rui Yan5Ru Yan6Shaobin Jia7Guangzhi Cong8Israel Gitangaza9Abdul Rehman10Institute of Medical Sciences, General Hospital of Ningxia Medical UniversityInstitute of Medical Sciences, General Hospital of Ningxia Medical UniversityInstitute of Medical Sciences, General Hospital of Ningxia Medical UniversityInstitute of Medical Sciences, General Hospital of Ningxia Medical UniversityInstitute of Medical Sciences, General Hospital of Ningxia Medical UniversityInstitute of Medical Sciences, General Hospital of Ningxia Medical UniversityInstitute of Medical Sciences, General Hospital of Ningxia Medical UniversityInstitute of Medical Sciences, General Hospital of Ningxia Medical UniversityInstitute of Medical Sciences, General Hospital of Ningxia Medical UniversitySchool of Clinical Medicine, Ningxia Medical UniversitySchool of Clinical Medicine, Ningxia Medical UniversityAbstract Background Transcatheter aortic valve replacement (TAVR) has emerged as a major therapeutic option for treating aortic stenosis. Hyponatremia is a common electrolyte disorder closely associated with adverse cardiovascular outcomes. However, large-scale studies investigating the impact of hypotonic hyponatremia on outcomes among TAVR patients are lacking. Methods We queried patients who underwent TAVR with concomitant hypo-osmolar hyponatremia (defined as a serum sodium concentration < 135 mEq/L with a serum osmolality < 280 mOsm/kg) using the National Inpatient Sample (2016–2021). Multivariate regression analysis and 1:1 propensity score matching (PSM) were performed to assess the associations between hypo-osmolar hyponatremia and in-hospital mortality and major adverse events (including acute kidney injury [AKI], acute myocardial infarction [AMI], and cardiogenic shock [CS]). Furthermore, sensitivity analysis was performed to assess the robustness of the findings. Results Among the total weighted national estimate of 370,680 patients who underwent TAVR, 13,865 (3.7%) had concomitant hypo-osmolar hyponatremia. These patients had a significantly increased risk of in-hospital mortality (aOR: 1.37; 95% CI: 1.08–1.74) and a greater likelihood of developing AKI (aOR: 3.39; 95% CI: 3.07–3.74), AMI (aOR: 3.20; 95% CI: 2.77–3.70), and CS (aOR: 2.96; 95% CI: 2.52–3.47). After PSM and sensitivity analysis, these associations remained significant. Conclusion In TAVR patients, hypo-osmolar hyponatremia is associated with increased in-hospital mortality and adverse events, including AKI, AMI, and CS.https://doi.org/10.1186/s12872-025-04564-4Transcatheter aortic valve replacementHyponatremiaCardiovascular outcomesAcute kidney injuryNational inpatient sample |
| spellingShingle | Shizhe Fu Kairu Wang Xueping Ma Bo Shi Congyan Ye Rui Yan Ru Yan Shaobin Jia Guangzhi Cong Israel Gitangaza Abdul Rehman Impact of hypotonic hyponatremia on outcomes in patients undergoing transcatheter aortic valve replacement: a national inpatient sample BMC Cardiovascular Disorders Transcatheter aortic valve replacement Hyponatremia Cardiovascular outcomes Acute kidney injury National inpatient sample |
| title | Impact of hypotonic hyponatremia on outcomes in patients undergoing transcatheter aortic valve replacement: a national inpatient sample |
| title_full | Impact of hypotonic hyponatremia on outcomes in patients undergoing transcatheter aortic valve replacement: a national inpatient sample |
| title_fullStr | Impact of hypotonic hyponatremia on outcomes in patients undergoing transcatheter aortic valve replacement: a national inpatient sample |
| title_full_unstemmed | Impact of hypotonic hyponatremia on outcomes in patients undergoing transcatheter aortic valve replacement: a national inpatient sample |
| title_short | Impact of hypotonic hyponatremia on outcomes in patients undergoing transcatheter aortic valve replacement: a national inpatient sample |
| title_sort | impact of hypotonic hyponatremia on outcomes in patients undergoing transcatheter aortic valve replacement a national inpatient sample |
| topic | Transcatheter aortic valve replacement Hyponatremia Cardiovascular outcomes Acute kidney injury National inpatient sample |
| url | https://doi.org/10.1186/s12872-025-04564-4 |
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