Can we use plasma hyperosmolality as a predictor of mortality for ST-segment elevation myocardial infarction?

Coron Artery Dis. 2017 Jan;28(1):70-76. doi: 10.1097/MCA.0000000000000426.

Abstract

Background: The aim of this study was to investigate the association of plasma osmolality with all-cause mortality in ST-segment elevation myocardial infarction (STEMI) patients treated with a primary percutaneous coronary intervention.

Methods: This study included 3748 patients (mean age 58.3±11.8 years, men 81%) with STEMI treated with primary percutaneous coronary intervention. The following formula was used to measure the plasma osmolality at admission: osmolality=1.86×sodium (mmol/l)+glucose (mg/dl)/18+BUN (mg/dl)/2.8+9.

Results: The patients were followed up for a mean period of 22±10 months. Patients with higher plasma osmolality had 3.7 times higher in-hospital (95% confidence interval: 2.7-5.1) and 3.2 times higher long-term (95% confidence interval: 2.5-4.1) all-cause mortality rates than patients with lower plasma osmolality.

Conclusion: Plasma osmolality was found to be a predictor of both in-hospital and long-term all-cause mortality. Hence, plasma osmolality can be used to detect high-risk patients in STEMI.

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Blood Glucose / analysis
  • Blood Urea Nitrogen
  • Female
  • Hospital Mortality
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Models, Biological
  • Osmolar Concentration
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / mortality*
  • Plasma*
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • ST Elevation Myocardial Infarction / blood
  • ST Elevation Myocardial Infarction / diagnosis*
  • ST Elevation Myocardial Infarction / mortality
  • ST Elevation Myocardial Infarction / therapy*
  • Sodium / blood
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • Blood Glucose
  • Sodium