AUTHOR=Huang Haozhang , Liu Jin , Liang Yan , Bao Kunming , Qiao Linfang , Liu Jiulin , Li Qiang , Wang Bo , Chen Shiqun , Lai Wenguang , Chen Cong , Zhang Lingyu , Huang Xiaoyu , Huang Dehua , Chen Jiyan , Tan Ning , Liu Yong 

TITLE=Prevalence and Mortality of Hypochloremia Among Patients Suffering From Coronary Artery Disease and Congestive Heart Failure: An Analysis of Patients in CIN-I and MIMIC-III Databases

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.769646

DOI=10.3389/fmed.2021.769646

ISSN=2296-858X

ABSTRACT=<p><bold>Background:</bold> Hypochloremia is an independent predictor for mortality in patients with coronary artery disease (CAD) but whether the same correlation exists in CAD patients with congestive heart failure (CHF) is unclear.</p><p><bold>Methods:</bold> This is an analysis of data stored in the databases of the CIN-I [a registry of Cardiorenal Improvement (NCT04407936) in China from January 2007 to December 2018] and Medical Information Mart for Intensive Care (MIMIC)-III. CAD patients with CHF were included. The outcome measures were 90-day all-cause mortality (ACM) and long-term ACM.</p><p><bold>Results:</bold> Data from 8,243 CAD patients with CHF were analyzed. We found that 10.2% of the study population had hypochloremia (Cl<sup>−</sup> &lt;98 mmol/L) in CIN-I (<italic>n</italic> = 4,762) and 20.1% had hypochloremia in MIMIC-III (<italic>n</italic> = 3,481). Patients suffering from hypochloremia were, in general, older and had a higher prevalence of comorbidities. After adjustment for confounders, hypochloremia remained a significant predictor of short-term mortality risk [90-day ACM: adjusted hazard ratio (a<italic>HR</italic>), 1.69; 95% CI, 1.27–2.25; <italic>P</italic> &lt; 0.001 in CIN-I, and 1.36 (1.17–1.59); <italic>P</italic> &lt; 0.001 in MIMIC-III]. Hypochloremia was also associated with long-term mortality [a<italic>HR</italic>, 1.26; 95% <italic>CI</italic>, 1.06–1.50; <italic>P</italic> = 0.009 in CIN-I, and 1.48 (1.32–1.66); <italic>P</italic> &lt; 0.001 in MIMIC-III]. Prespecified subgroup analyses revealed an association of hypochloremia with long-term ACM to be attenuated slightly in the women of the two databases (<italic>P</italic> interaction &lt; 0.05).</p><p><bold>Conclusions:</bold> Hypochloremia is independently associated with higher short-term and long-term ACM. Further studies are needed to determine if early preventive measurements and active intervention of hypochloremia can reduce the mortality risk of CAD patients with CHF.</p>