Three gram sodium intake is associated with longer event-free survival only in patients with advanced heart failure

Terry A. Lennie, Eun Kyeung Song, Jia Rong Wu, Misook L. Chung, Sandra B. Dunbar, Susan Pressler, Debra K. Moser

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

Background: There is limited evidence to support the recommendation that patients with heart failure (HF) restrict sodium intake. The purpose of this study was to compare differences in cardiac event-free survival between patients with sodium intake above and below 3 g. Methods: A total of 302 patients with HF (67% male, 62 ± 12 years, 54% New York Heart Association [NYHA] Class III/IV, ejection fraction 34 ± 14%) collected a 24-hour urine sodium (UNa) to indicate sodium intake. Patients were divided into 2 groups using a 3-g UNa cutpoint and stratified by NYHA Class (I/II vs. III/IV). Event-free survival for 12 months was determined by patient or family interviews and medical record review. Differences in cardiac event-free survival were determined by Kaplan-Meier survival curve with log-rank test and Cox hazard regression. Results: The Cox regression hazard ratio for 24-hour UNa ≥ 3 g in NYHA Class I/II was 0.44 (95% confidence interval [CI] = 0.20-0.97) and 2.54 (95% CI = 1.10-5.84) for NYHA III/IV after controlling for age, gender, HF etiology, body mass index, ejection fraction, and total comorbidity score. Conclusions: These data suggest that 3 g dietary sodium restriction may be most appropriate for patients in NYHA functional Classes III and IV.

Original languageEnglish (US)
Pages (from-to)325-330
Number of pages6
JournalJournal of Cardiac Failure
Volume17
Issue number4
DOIs
StatePublished - Apr 2011
Externally publishedYes

Fingerprint

Disease-Free Survival
Heart Failure
Sodium
Confidence Intervals
Dietary Sodium
Kaplan-Meier Estimate
Medical Records
Comorbidity
Body Mass Index
Urine
Interviews

Keywords

  • Diet
  • NYHA class
  • sodium restriction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Three gram sodium intake is associated with longer event-free survival only in patients with advanced heart failure. / Lennie, Terry A.; Song, Eun Kyeung; Wu, Jia Rong; Chung, Misook L.; Dunbar, Sandra B.; Pressler, Susan; Moser, Debra K.

In: Journal of Cardiac Failure, Vol. 17, No. 4, 04.2011, p. 325-330.

Research output: Contribution to journalArticle

Lennie, Terry A. ; Song, Eun Kyeung ; Wu, Jia Rong ; Chung, Misook L. ; Dunbar, Sandra B. ; Pressler, Susan ; Moser, Debra K. / Three gram sodium intake is associated with longer event-free survival only in patients with advanced heart failure. In: Journal of Cardiac Failure. 2011 ; Vol. 17, No. 4. pp. 325-330.
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abstract = "Background: There is limited evidence to support the recommendation that patients with heart failure (HF) restrict sodium intake. The purpose of this study was to compare differences in cardiac event-free survival between patients with sodium intake above and below 3 g. Methods: A total of 302 patients with HF (67{\%} male, 62 ± 12 years, 54{\%} New York Heart Association [NYHA] Class III/IV, ejection fraction 34 ± 14{\%}) collected a 24-hour urine sodium (UNa) to indicate sodium intake. Patients were divided into 2 groups using a 3-g UNa cutpoint and stratified by NYHA Class (I/II vs. III/IV). Event-free survival for 12 months was determined by patient or family interviews and medical record review. Differences in cardiac event-free survival were determined by Kaplan-Meier survival curve with log-rank test and Cox hazard regression. Results: The Cox regression hazard ratio for 24-hour UNa ≥ 3 g in NYHA Class I/II was 0.44 (95{\%} confidence interval [CI] = 0.20-0.97) and 2.54 (95{\%} CI = 1.10-5.84) for NYHA III/IV after controlling for age, gender, HF etiology, body mass index, ejection fraction, and total comorbidity score. Conclusions: These data suggest that 3 g dietary sodium restriction may be most appropriate for patients in NYHA functional Classes III and IV.",
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