- Low sodium chloride levels may be adverse prognostic markers in patients with chronic heart failure irrespective of variables such as amino-terminal pro-B-type natriuretic peptide (NT-proBNP) or sodium.
Why this matters
- The importance of serum chloride levels has been overlooked until now.
- This study suggests novel findings: association between chloride levels and sudden death, biochemical phenotypes of hypochloraemia with implications for management.
- Study enrolled 4705 patients with heart failure who had baseline data on ECG, NT-proBNP and serum chloride levels.
- The primary outcomes assessed were all-cause mortality and a composite endpoint of mortality/hospitalisation with heart failure.
- Funding: None disclosed.
- 1988 patients had heart failure with reduced ejection fraction (HFrEF) and 2717 patients had heart failure with preserved ejection fraction (HFpEF).
- Patients in the first quartile (median chloride, 96 mmol/L) vs second to fourth quartile (median chloride, 106 mmol/L) had:
- Greater severity of symptoms (P<.001 and>
- Greater likelihood for receiving loop diuretics (P<.001>
- Potential risk of confounders.