The occurrence of hyponatremia and its effect on in-hospital outcome in patient of Acute ST elevated myocardial infarction.


  • Gulshan Ahmad Punjab Institute of Cardiology, Lahore
  • Tariq Ahmad National Institute of Cardiovascular Diseases, Karachi
  • Samar Arfeen Punjab Institute of Cardiology, Lahore
  • Nauman Saleem Punjab Institute of Cardiology, Lahore
  • Salman Ahmad Saleem National Institute of Cardiovascular Diseases, Karachi
  • Naveed Iqbal National Institute of Cardiovascular Diseases, Karachi



Hyponatremia, acute ST elevated myocardial infarction and in-hospital


INTRODUCTION: Hyponatremia is regarded as the most commonly occurring disorder of electrolyte observed in patients in diverse hospital settings. Hyponatremia if becomes severe, may become life-threatening leading to drastic neurological complicationsDue to it being marker for identification of underlying medical conditions, it is often associated with inadequate prognostication, even when level of sodium in serum is reduced mildly only. Development of hyponatremia begins during ST-elevation myocardial infarction’s acute phase due to neurohormonal activation. The aim of this study is to ascertain hyponatremia’s prognostic value amidst acute phase of myocardial infarction.


AIMS & OBJECTIVE: To ascertain hyponatremia’s frequency and the impact on the outcome of in-hospital patients suffering with acute ST elevated myocardial infarction.


MATERIAL AND METHODS: This was a descriptive study which was carried out at Aga Khan University Hospital, Karachi (AKUH) over a period of six months. After obtaining consent of the patients, their data was collected prospectively. Inclusion of the patients was dependent upon diagnostic criteria and 225 individuals were selected. For quantitative data we used mean±standard deviation while the categorial variables were expressed as percentages and frequency. Scarification was used to control effect modifiers to observe their effect on output variable. A chi-square test was carried out post stratification and a p-value of ?0.05 was determined as significant.


RESULTS: Overall, 225 patients admitted in department of Cardiology, Aga Khan University Hospital, Karachi were made part of this study. The mean age was 56.80±7.56 years in the present study. There were 135 (60%) male and 90 (40%) female patients. Out of 225 patients, 43 (19.1%) had hyponatremia. In-hospital mortality was 22 (100%) who had hyponatremia.

CONCLUSION: Hyponatremia in patients with acute STEMI is observed as a major predictor related to cardiovascular mortality. Level of sodium in the plasma might serve to be a relatively simple marker for the identification of patients who are at risk.

Author Biographies

Gulshan Ahmad, Punjab Institute of Cardiology, Lahore

Senior Registrar Cardiology

Tariq Ahmad, National Institute of Cardiovascular Diseases, Karachi

FCPS Interventional Cardiology Fellow

Samar Arfeen, Punjab Institute of Cardiology, Lahore

Senior Registrar Cardiology

Nauman Saleem, Punjab Institute of Cardiology, Lahore

Senior Registrar Cardiology

Salman Ahmad Saleem, National Institute of Cardiovascular Diseases, Karachi

Senior Registrar Cardiology

Naveed Iqbal, National Institute of Cardiovascular Diseases, Karachi

Senior Registrar Cardiology


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