Acta Pharmacologica Sinica 2007 August; 28 (8): 1136-1142; doi: 10.1111/j.1745-7254.2007.00597.x

Aim: To explore the relationship between serum sodium concentration and coronary atherosclerosis.

Methods: The study population consisted of 896 consecutive patients (684 males and 212 females) who underwent coronary angiography for suspected or known coronary atherosclerosis. Smoking and drinking were investigated. The anthropometric measurements, including body mass index, systolic blood pressure and diastolic blood pressure, and the serum measurements, including sodium, potassium, chlorine, lipids, blood glucose, urea, creatinine, and uric acid for every patient were conducted. The severity of coronary atherosclerosis was defined by the Gensini score system. The statistical methods, including one-way ANOVA, Kruskal-Wallis test, Spearman correlation analysis, partial correlation analysis, multivariate stepwise linear regression analysis, and multinomial logistic regression analysis were employed to explore the relationship between serum sodium concentration and the Gensini score.

Results: The analysis of the Kruskal-Wallis test indicated that the distribution of the Gensini score (P=0.000) differed among the groups according to serum sodium concentration, quartile values of which were used as cut-off points. The Spearman correlation and partial correlation analysis controlling for gender, smoking status, and drinking status indicated that the Gensini score significantly correlated with the sodium concentration (r=-0.241, P=0.000 for the Spearman correlation, r=-0.114, P=0.000 for the partial correlation). The results from the multivariate stepwise linear regression analysis showed that the left ventricular ejection fraction (β=-0.228, P=0.000), age (β=0.137, P=0.010), glucose level (β=0.129, P=0.000), and sodium level (β=-0.106, P=0.004) were significantly and independently associated with the Gensini score. The results of the multinomial logistic regression analysis suggested that the hyponatremia was the risk factor for the higher Gensini score.

Conclusion: The serum sodium concentration was significantly and negatively associated with the Gensini score; and the actual mechanism underlying the association needs further study.

Keywords: sodium; coronary atherosclerosis; Gensini score