{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:48:13Z","timestamp":1768438093982,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T00:00:00Z","timestamp":1705363200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The difference between serum sodium and chloride ion concentrations (SCD) may be considered as a surrogate of a strong ion difference and may help to identify patients with a worse prognosis. We aimed to assess SCD as an early prognostic marker among patients with myocardial infarction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data of 594 consecutive patients with acute myocardial infarction treated with PCI (44.9% STEMI patients; 70.7% males) was analysed for SCD in relation to their 30\u2010day mortality. A restricted cubic spline regression model was used to study the relationship between mortality and SCD. Cox regression models were used to assess the association between SCD and the mortality risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with Killip class \u22653 had lower SCD values in comparison to patients with Killip class \u22642: (32.0 [30.0\u201334.0] vs. 33.0 [31.0\u201336.0], <jats:italic>p<\/jats:italic>\u2009=\u2009.006). The overall 30\u2010day mortality was 7.7% (<jats:italic>n<\/jats:italic>\u2009=\u200946). There was a significant difference in SCD values between survivors and non\u2010survivors groups of patients (median (IQR): (33.0 [31.0\u201336.0] vs. 31.5 [28.0\u201334.0] (mmol\/L), p\u2009=\u2009.002). The restricted cubic splines model confirmed a non\u2010linear association between SCD and mortality. Patients with SCD &lt;30\u2009mmol\/L (in comparison to SCD \u226530\u2009mmol\/L) had an increased mortality risk (unadjusted HR 2.92, 95% CI 1.59\u20135.36, <jats:italic>p<\/jats:italic>\u2009=\u2009.001; and an adjusted HR 2.30, 95% CI 1.02\u20135.19, <jats:italic>p<\/jats:italic>\u2009=\u2009.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Low SCD on admission is associated with an increased risk of 30\u2010day mortality in patients with acute myocardial infarction treated with PCI and may serve as a useful prognostic marker for these patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.14157","type":"journal-article","created":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T09:17:23Z","timestamp":1705396643000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The sodium\u2013chloride difference: A marker of prognosis in patients with acute myocardial infarction"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1762-8043","authenticated-orcid":false,"given":"Micha\u0142","family":"Terlecki","sequence":"first","affiliation":[{"name":"Department of Interdisciplinary Intensive Care, Jagiellonian University Medical College  Krak\u00f3w Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryla","family":"Kocowska\u2010Trytko","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension Jagiellonian University Medical College  Krak\u00f3w Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksandra","family":"Kurzyca","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension Jagiellonian University Medical College  Krak\u00f3w 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Arterial Hypertension Jagiellonian University Medical College  Krak\u00f3w Poland"},{"name":"Student's Scientific Group in the 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension Jagiellonian University Medical College  Krak\u00f3w Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pawe\u0142","family":"Lis","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension Jagiellonian University Medical College  Krak\u00f3w Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Bednarski","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension Jagiellonian University Medical College  Krak\u00f3w 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