Journal
JOURNAL OF CARDIAC FAILURE
Volume 17, Issue 4, Pages 325-330Publisher
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.cardfail.2010.11.008
Keywords
Diet; sodium restriction; NYHA class
Categories
Funding
- NIH NINR [R01 NR 009280]
- General Clinical Research Centers at University of Kentucky [M01RR02602]
- Emory University [M01RR0039]
- Indiana University [MO1 RR000750]
- NIH, NINR Center [1P20NR010679]
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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. (J Cardiac Fail 2011;17:325-330)
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