(HealthDay News) — Serum chloride levels at admission are associated with mortality among patients with acute decompensated heart failure (ADHF), according to a study published in the Journal of the American College of Cardiology.

Justin L. Grodin, M.D., from the Cleveland Clinic, and colleagues examined the prognostic significant of sodium chloride levels in relation to serum sodium levels in a cohort of 1,318 patients with chronic heart failure admitted for ADHF. Findings were validated in an independent cohort of 876 ADHF patients.

The researchers observed an independent and inverse association for admission serum chloride levels during hospitalization for ADHF and long-term mortality (hazard ratio [HR] per unit change, 0.94; P < 0.001). After multivariable risk adjustment, admission chloride levels, but not sodium levels, remained independently associated with mortality (HR per unit change, 0.93; P < 0.001 and P > 0.05, respectively). Similar results were seen in the validation cohort in unadjusted and multivariable risk-adjusted analyses (HRs per unit change for mortality risk within one year, 0.93 [P < 0.001] and 0.95 [P = 0.01], respectively).

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“These observations in a contemporary advanced ADHF cohort suggest that serum chloride levels at admission are independently and inversely associated with mortality,” the authors write. “The prognostic value of serum sodium in ADHF was diminished compared with chloride.”


  1. Grodin, JL; Simon, J; Hachamovitch, R; et al. J Am Coll Cardiol. 2015;66(6):659-666; doi:10.1016/j.jacc.2015.06.007.
  2. O’Connor, CM and Ahmad, T. J Am Coll Cardiol. 2015;66(6):667-669; doi:10.1016/j.jacc.2015.05.070.