
This study comprehensively assessed the prevalence, associations, hospital course, and post-discharge outcomes of hyponatremia in acute heart failure (AHF). Among 8,298 patients with AHF, 20% had hyponatremia. Independent predictors included lower blood pressure, kidney function, hemoglobin levels, diabetes, liver disease, and medication usage. In-hospital mortality was 3.3%. Hyponatremia at admission and discharge was associated with higher in-hospital mortality, while hyponatremia developing during hospitalization had a lower risk. Among hospital survivors, 12-month mortality and heart failure hospitalization rates were higher for patients with hyponatremia. Early identification and management of hyponatremia may improve outcomes in AHF patients.
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