Abstract 16041: 3,500mg Urine Sodium Predicted Event-Free Survival in Heart Failure Patients with Depressive Symptoms
Background: Patients with heart failure (HF) experience high rates of hospitalization and death. Poor adherence to low sodium diet and the presence of depressive symptoms may be related to poor outcomes. Low sodium intake is recommended to decrease risk of hospitalization and death. Depressive symptoms affect self-care ability and are a predictor of hospitalization and death. The purpose of this study was to examine cpmpare whether sodium intake predicted cardiac-related event-free survival in depressed vs. non-depressed patients with HF.
Method: Patients (N = 197, mean age 61, 68% male, New York Heart Association functional class [NYHA] III/IV: 50%) provided urine for analysis of 24-hour sodium excretion, depressive symptoms (Beck Depression Inventory II), and event-free survival. Patients were categorized into low and high sodium groups (cut point = 3500 mg) based on 24-hour urine sodium and depressed and non-depressed groups (cut point = 14). Data on event-free survival were collected through patient and family interview and medical record review. Cox regression was used to determine if sodium intake predicted cardiac event-free survival in groups stratified by depressive symptoms.
Results: There were 52 cardiac-related events during the median 366 days of follow-up. In the group with high depressive symptoms, urine sodium of 3,500 mg was a predictor after controlling for age, gender, marital status, NYHA class, comorbidity, HF etiology, and left ventricular ejection fraction (Hazard ratio = 3.6, p = .005). In the non-depressed group, urine sodium was not a predictor of event-free survival.
Conclusions: Urine sodium < 3,500 mg was predictive of better event-free survival but only in HF patients with depressive symptoms. Patients with depressive symptoms may be more vulnerable to high sodium intake and therefore may merit additional help with limiting dietary sodium.
- © 2010 by American Heart Association, Inc.