Can we use plasma hyperosmolality as a predictor of mortality for ST-segment elevation myocardial infarction?

Background The aim of this study was to investigate the association of plasma osmolality with all-cause mortality in ST-segment elevation myocardial infarction (STEMI) patients treated with a primary percutaneous coronary intervention. Methods This study included 3748 patients (mean age 58.3 +/- 11.8 years, men 81%) with STEMI treated with primary percutaneous coronary intervention. The following formula was used to measure the plasma osmolality at admission: osmolality = 1.86 x sodium (mmol/l) + glucose (mg/dl)/18 + BUN (mg/dl)/2.8 + 9. Results The patients were followed up for a mean period of 22 +/- 10 months. Patients with higher plasma osmolality had 3.7 times higher in-hospital (95% confidence interval: 2.7-5.1) and 3.2 times higher long-term (95% confidence interval: 2.5-4.1) all-cause mortality rates than patients with lower plasma osmolality. Conclusion Plasma osmolality was found to be a predictor of both in-hospital and long-term all-cause mortality. Hence, plasma osmolality can be used to detect high-risk patients in STEMI. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.