Association of an increase in serum albumin levels with positive 1-year outcomes in acute decompensated heart failure: A cohort study.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
25
09
2020
accepted:
27
11
2020
entrez:
28
12
2020
pubmed:
29
12
2020
medline:
4
2
2021
Statut:
epublish
Résumé
Despite the prognostic importance of hypoalbuminemia, the prognostic implication of a change in albumin levels has not been fully investigated during hospitalization in patients with acute decompensated heart failure (ADHF). Using the data from the Kyoto Congestive Heart Failure registry on 3160 patients who were discharged alive for acute heart failure hospitalization and in whom the change in albumin levels was calculated at discharge, we evaluated the association with an increase in serum albumin levels from admission to discharge and clinical outcomes by a multivariable Cox hazard model. The primary outcome measure was a composite of all-cause death or hospitalization for heart failure. Patients with increased albumin levels (N = 1083, 34.3%) were younger and less often had smaller body mass index and renal dysfunction than those with no increase in albumin levels (N = 2077, 65.7%). Median follow-up was 475 days with a 96% 1-year follow-up rate. Relative to the group with no increase in albumin levels, the lower risk of the increased albumin group remained significant for the primary outcome measure (hazard ratio: 0.78, 95% confidence interval: 0.69-0.90: P = 0.0004) after adjusting for confounders including baseline albumin levels. When stratified by the quartiles of baseline albumin levels, the favorable effect of increased albumin was more pronounced in the lower quartiles of albumin levels, but without a significant interaction effect (interaction P = 0.49). Independent of baseline albumin levels, an increase in albumin during index hospitalization was associated with a lower 1-year risk for a composite of all-cause death and hospitalization in patients with acute heart failure.
Sections du résumé
BACKGROUND
Despite the prognostic importance of hypoalbuminemia, the prognostic implication of a change in albumin levels has not been fully investigated during hospitalization in patients with acute decompensated heart failure (ADHF).
METHODS
Using the data from the Kyoto Congestive Heart Failure registry on 3160 patients who were discharged alive for acute heart failure hospitalization and in whom the change in albumin levels was calculated at discharge, we evaluated the association with an increase in serum albumin levels from admission to discharge and clinical outcomes by a multivariable Cox hazard model. The primary outcome measure was a composite of all-cause death or hospitalization for heart failure.
FINDINGS
Patients with increased albumin levels (N = 1083, 34.3%) were younger and less often had smaller body mass index and renal dysfunction than those with no increase in albumin levels (N = 2077, 65.7%). Median follow-up was 475 days with a 96% 1-year follow-up rate. Relative to the group with no increase in albumin levels, the lower risk of the increased albumin group remained significant for the primary outcome measure (hazard ratio: 0.78, 95% confidence interval: 0.69-0.90: P = 0.0004) after adjusting for confounders including baseline albumin levels. When stratified by the quartiles of baseline albumin levels, the favorable effect of increased albumin was more pronounced in the lower quartiles of albumin levels, but without a significant interaction effect (interaction P = 0.49).
CONCLUSIONS
Independent of baseline albumin levels, an increase in albumin during index hospitalization was associated with a lower 1-year risk for a composite of all-cause death and hospitalization in patients with acute heart failure.
Identifiants
pubmed: 33370299
doi: 10.1371/journal.pone.0243818
pii: PONE-D-20-30330
pmc: PMC7769473
doi:
Substances chimiques
Serum Albumin
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0243818Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
ESC Heart Fail. 2017 Aug;4(3):216-223
pubmed: 28772047
JAMA Netw Open. 2020 May 1;3(5):e204296
pubmed: 32379331
Circ J. 2018 Oct 25;82(11):2811-2819
pubmed: 30259898
Circ Heart Fail. 2013 Mar;6(2):227-32
pubmed: 23395932
J Card Fail. 2014 Sep;20(9):641-9
pubmed: 24996200
Bone Marrow Transplant. 2013 Mar;48(3):452-8
pubmed: 23208313
J Card Fail. 2011 Jun;17(6):451-8
pubmed: 21624732
Sci Rep. 2020 Feb 24;10(1):3320
pubmed: 32094392
Am J Cardiovasc Drugs. 2018 Aug;18(4):327-332
pubmed: 29511994
Life Sci. 2015 Sep 15;137:20-7
pubmed: 26141987
Eur J Heart Fail. 2009 Feb;11(2):170-7
pubmed: 19168515
Nat Rev Cardiol. 2016 Jun;13(6):368-78
pubmed: 26935038
JAMA Netw Open. 2019 Jun 5;2(6):e195892
pubmed: 31225889
Eur J Heart Fail. 2016 Aug;18(8):891-975
pubmed: 27207191
Int J Cardiol. 2015;187:27-8
pubmed: 25828304
Int J Cardiol. 2008 Apr 10;125(2):265-7
pubmed: 18029037
J Card Fail. 2014 May;20(5):350-8
pubmed: 24486927
Am J Cardiol. 2016 Apr 15;117(8):1305-9
pubmed: 27020611