Abstract 12127: Hyponatremia is Associated With Higher Readmission Rates in Patients With Left Ventricular Assist Devices

Introduction:Hyponatremia is associated with increased morbidity and mortality in heart failure (HF) patients. The implication of hyponatremia post-left ventricular assist device (LVAD) remains unknown.Hypothesis:We hypothesized that LVAD patients with hyponatremia would have increased morbidity and mortality.Methods:A retrospective study of VAD patients between 4/2014-3/2018. Patients with LVAD exchange or right VAD implantation were excluded. Patients were stratified by the presence of hyponatremia (Na<135) at 30 days post-LVAD. Clinical variables included Na levels pre-LVAD and up through 1-year post-LVAD. HF readmissions and survival during 1-year follow-up were compared between the groups.Results:Of 204 patients identified, 170 with LVAD implantation were included in the study. Mean age was 55, 31% were male, and 29% had ischemic cardiomyopathy. Na levels improved from pre-LVAD to 1-year (135.9 ? 4.5 mEq/L to 138.9 ? 3.7 mEq/L, P<0.001). At 30 days, 35 patients were in the hyponatremia group and 135 patients were in the control group. No significant difference was observed for 1-year survival between the groups (81% vs. 77%, P=0.66; Figure 1A). The control group had significantly better 1-year freedom from HF readmission compared to the hyponatremia group (85% vs. 56%, P=0.001; Figure 1B). Among patients with normonatremia (N=110), those who developed de novo hyponatremia (N=17) had lower freedom from HF readmission than those who remained normonatremic (55% vs. 84%, P=0.022; Figure 1C). Among patients with hyponatremia (N=60), those who had persistent hyponatremia (N=18) had decreased freedom from HF readmission than those who improved to normonatremia (56% vs. 88%, P=0.008; Figure 1D).Conclusions:Hyponatremia in LVAD patients is associated with increased HF readmissions but not increased mortality. Further studies need to elucidate whether therapies directed at hyponatremia (tolvaptan) would improve outcomes in LVAD patients.