Importance of the Corrected Calcium Level in Patients With Acute Heart Failure Requiring Intensive Care

Figures

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  Figure 1.. The patient selection process. Between January 2000 and January 2018, 1,378 patients who were admitted to the intensive care unit at Nippon Medical School Chiba Hokusoh Hospital were screened. Of these, 20 patients whose serum calcium (Ca) levels were not measured and 67 patients whose serum Ca levels were not measured within 24 h of admission were excluded. Ultimately, 1,291 patients with acute heart failure (AHF) were enrolled in the present study. Patients were divided into the hypocalcemia (n=651), pseudo-hypocalcemia (n=300), and normal/hypercalcemia (n=340) groups, and were assigned to the corrected hypocalcemia (n=651) and corrected normal/hypercalcemia (n=640) groups.

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  Figure 2.. Distribution of the original and corrected calcium (Ca) concentrations.

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  Figure 3.. Kaplan-Meier survival curves for the hypocalcemia (n=651), pseudo-hypocalcemia (n=300), and normal/hypercalcemia (n=340) groups. Prognosis for (A) all-cause death and (B) heart failure (HF) events within 730 days was significantly poorer in the pseudo-hypocalcemia than in the hypocalcemia and normal/hypercalcemia groups.

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  Figure 4.. Kaplan-Meier survival curves for the corrected hypocalcemia (n=651) and corrected normal/hypercalcemia (n=640) groups. (A) Prognosis for all-cause death within 730 days was significantly better in the corrected hypocalcemia group than in the corrected normal/hypercalcemia group. (B) There was no significant difference in HF events within 730 days between the 2 groups.

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  Figure 5.. The Kaplan-Meier survival curves for the serum albumin ≥3.5 g/dL group (n=834), 3.0 g/dL ≤ serum albumin ≤3.4 g/dL (n=336) and 2.9 g/dL ≥ serum albumin group. (A) Prognosis for (A) all-cause death and (B) heart failure (HF) events within 730 days was significantly poorer in patients with serum albumin ≤2.9 g/dL than those with serum albumin 3.0–3.4 g/dL or ≥3.5 g/dL.