Karaye KM, Ishaq NA, Saidu H, Balarabe SA, Talle MA, Isa MS. Prognostic significance of hyponatremia in peripartum cardiomyopathy. World J Methodol 2025; 15(4): 101181 [DOI: 10.5662/wjm.v15.i4.101181]
Corresponding Author of This Article
Kamilu M Karaye, BM BCh, FACC, FESC, FRCP, MSc, PhD, Professor, Department of Medicine, Aminu Kano Teaching Hospital, 2 Zaria Road, Kano 700233, Nigeria. kkaraye@yahoo.co.uk
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Methodol. Dec 20, 2025; 15(4): 101181 Published online Dec 20, 2025. doi: 10.5662/wjm.v15.i4.101181
Prognostic significance of hyponatremia in peripartum cardiomyopathy
Kamilu M Karaye, Naser A Ishaq, Hadiza Saidu, Sulaiman A Balarabe, Mohammed Abdullahi Talle, Muhammad S Isa
Kamilu M Karaye, Naser A Ishaq, Department of Medicine, Aminu Kano Teaching Hospital, Kano 700233, Nigeria
Kamilu M Karaye, Hadiza Saidu, Department of Medicine, Bayero University, Kano 700006, Nigeria
Kamilu M Karaye, Department of Public Health and Clinical Medicine, Umea University, Umea 90187, Sweden
Sulaiman A Balarabe, Department of Medicine, Muhammad Abdullahi Wase Specialist Hospital, Kano 700213, Nigeria
Mohammed Abdullahi Talle, Department of Medicine, University of Maiduguri Teaching Hospital, Maiduguri 600230, Borno, Nigeria
Muhammad S Isa, Department of Medicine, Ahmadu Bello University Teaching Hospital, Zaria 810107, Kaduna, Nigeria
Author contributions: Karaye KM conceptualised and designed the study, and acquired, analysed and interpreted data, drafted the article and revised it critically for important intellectual content, and approved the final submitted version. All other authors acquired, analysed and interpreted data, revised the article critically for important intellectual content, and approved the final submitted version. All authors read and approved the final manuscript.
Institutional review board statement: Ethical approval for the study was obtained from the Research Ethics Committees of all the participating centres before the commencement of the study.
Informed consent statement: PPCM patients were enrolled into the study after obtaining written informed consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement:sharing statement: All data and supporting materials have been provided with the published article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kamilu M Karaye, BM BCh, FACC, FESC, FRCP, MSc, PhD, Professor, Department of Medicine, Aminu Kano Teaching Hospital, 2 Zaria Road, Kano 700233, Nigeria. kkaraye@yahoo.co.uk
Received: September 6, 2024 Revised: February 26, 2025 Accepted: March 18, 2025 Published online: December 20, 2025 Processing time: 332 Days and 3.5 Hours
Abstract
BACKGROUND
Hyponatremia is the most common electrolyte imbalance, however the prognostic significance of hyponatremia in peripartum cardiomyopathy (PPCM) remains unclear.
AIM
To assess the prognostic significance of hyponatremia in PPCM patients.
METHODS
We consecutively recruited patients with PPCM from 14 sites in Nigeria and followed them up for a median of 18 months. Serum sodium was measured at baseline, and patients with hyponatremia (< 135 mmol/L) were compared with those with normal sodium levels. Cox proportional hazards regression models were developed to identify factors associated with all-cause mortality.
RESULTS
Of the 191 PPCM patients recruited, 90 (47.1%) had hyponatremia at presentation. All-cause mortality among the hyponatremic patients (24/90; 26.7%) was significantly higher than among patients with normal serum sodium (7/101; 6.9%) (P-value < 0.001). In the Cox proportional hazards regression model, hyponatremia was independently associated with an increased risk of all-cause mortality [hazard ratio: 3.18 (95% confidence interval: 1.35-7.52; P = 0.008)], as were hypotension (systolic blood pressure < 100 mmHg) [2.22 (1.03-4.79); P = 0.043] and left ventricular ejection fraction (LVEF) < 25% [3.14 (1.47-6.73), P = 0.003].
CONCLUSION
Hyponatremia was common in our cohort of PPCM patients, and was independently associated with a threefold increased risk for all-cause mortality. Hypotension and a LVEF below 25% at presentation were also independent predictors of mortality.
Core Tip: Hyponatremia was common in our cohort of peripartum cardiomyopathy (PPCM) patients, and independently associated with threefold increased risk for all-cause mortality. Hypotension and a left ventricular ejection fraction below 25% at presentation were also independently associated with mortality. Our findings suggest that presence of hyponatraemia in PPCM patients at admission should prompt a thorough clinical evaluation and close clinical monitoring, to identify and address factors contributing to increased mortality risk.
