Associations between serum electrolyte and short-term outcomes in patients with acute decompensated heart failure

There is a dearth of comprehensive studies on the association between serum electrolyte and adverse short-term prognosis of Chinese patients with acute decompensated heart failure (ADHF). A total of 5166 patients with ADHF were divided into four serum electrolyte-related study populations (potassium (n = 5145), sodium (n = 5135), chloride (n = 4966), serum total calcium (STC) (n = 4143)) under corresponding exclusions. Different logistic regression models were utilized to gauge the association between these electrolytes or the number of electrolyte abnormalities and the risk of a composite of all-cause mortality or 30-day heart failure (HF) readmission. In multivariable adjusted analysis, patients with potassium below 3.5 mmol/L (odds ratios (ORs) 1.45; 95% confidence interval (CI):1.07–1.95), 4.01–4.50 mmol/L (OR: 1.29, CI: 1.02–1.62), 4.51–5.00 mmol/L (OR: 1.43, CI: 1.08–1.90) and above 5.00 mmol/L (OR: 1.74, CI: 1.21–2.51) had an increased risk of outcome when compared with potassium at 3.50–4.00 mmol/L. Sodium levels were inversely related to the risk of a composite outcome (p for trend N = 1, OR 1.40, 95% CI: 1.13–1.73; N = 2, OR 2.51, 95% CI: 1.85–3.42; N = 3, OR 2.47, 95% CI: 1.45–4.19; p for trend N = 0. A deviation of potassium levels from 3.50 to 4.00 mmol/L, lower sodium levels and hypochloremia were associated with poorer short-term prognosis of ADHF. Furthermore, the number of electrolyte abnormalities positively correlated with adverse short-term prognosis of patients with ADHF. Key MessagesADHF patients with baseline serum potassium at first half part of normal range (3.50–4.00 mmol/L) may herald the lowest risk of recent cardiovascular events.Serum sodium and chloride levels exhibit discrepancies in terms of risk of short-term adverse events of ADHF patients.The number of electrolyte abnormalities is a significant predictor of poor short-term prognosis in patients with ADHF. ADHF patients with baseline serum potassium at first half part of normal range (3.50–4.00 mmol/L) may herald the lowest risk of recent cardiovascular events. Serum sodium and chloride levels exhibit discrepancies in terms of risk of short-term adverse events of ADHF patients. The number of electrolyte abnormalities is a significant predictor of poor short-term prognosis in patients with ADHF. http://www.chictr.org.cn/showproj.aspx?proj=23139. Unique identifier: ChiCTR-POC-17014020.