Rasio Natrium terhadap Klorida dengan Kejadian Kardiovaskular Mayor Hingga 7 Hari Pasca Rawatan Pasien Gagal Jantung Akut Di Rs Adam Malik Medan

Abstract

Objective: Acute heart failure (AHF) can be defined as a critical medical condition resulting from the heart's inability to pump blood efficiently. A key aspect in the management of AHF is predicting major adverse cardiovascular events (MACEs) during the "acute phase," with monitoring laboratory findings considered as a potential prognostic tool. This study aims to determine the relationship between the sodium/chloride (Na/Cl) ratio and the risk of MACEs in AHF patients during the first 7 days of hospitalization. Methods: This observational, single-center, cross-sectional study was conducted at Adam Malik Hospital, Medan, Indonesia, from May to October 2024. The researchers included AHF patients with complete Na/Cl ratio data (with a cut-off of 1.3) at initial presentation, who were subsequently hospitalized for at least 7 days to evaluate the risk of MACEs. Statistical analysis was performed using SPSS version 24.0. Results: We included a total of 50 AHF patients (70.0% male) with a mean age of 58.98 ± 11.42 years into the final analysis, with 80.0% were diagnosed with acute de novo heart failure (ADHF). A higher proportion of MACEs was observed in the group with an elevated Na/Cl ratio (76.3% vs 33.3%; P=0.012). However, no such association was found when analyzing sodium or chloride levels individually, nor was there any correlation with in-hospital mortality (P>0.05). Interestingly, higher Na/Cl ratios and lower chloride levels were found in the MACE group (P<0.05). Diagnostic performance analysis showed that the Na/Cl ratio had a sensitivity of 63.6% and specificity of 64.7%, respectively. Conclusion: The Na/Cl ratio is a reasonably reliable parameter for predicting MACEs, as an increase in this metric indicates a higher risk of MACEs