Albumin levels predict survival in patients with systolic heart failure
Background Hypoalbuminemia is associated with poor prognosis in patients with certain chronic diseases, such as end-stage renal disease and cancer. Although low serum albumin is common in patients with heart failure (HF), the relationship between albumin and HF prognosis has not been well characteri...
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| Veröffentlicht in: | The American heart journal 2008-05, Vol.155 (5), p.883-889 |
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| creator | Horwich, Tamara B., MD, MS Kalantar-Zadeh, Kamyar, MD, PhD MacLellan, Robb W., MD Fonarow, Gregg C., MD, FACC |
| description | Background Hypoalbuminemia is associated with poor prognosis in patients with certain chronic diseases, such as end-stage renal disease and cancer. Although low serum albumin is common in patients with heart failure (HF), the relationship between albumin and HF prognosis has not been well characterized. This study investigated the effect of serum albumin level on survival in patients with advanced HF. Methods We analyzed 1726 systolic HF patients (age 52 ± 13 years, ejection fraction [EF] 23% ± 7%) followed at a university HF center. Albumin level was determined at initial referral. Patients were divided by into groups based on presence of hypoalbuminemia (≤3.4 g/dL). Mean albumin was 3.8 ± 0.6 g/dL, and 25% of patients had hypoalbuminemia. Results Patients with and without low albumin levels were similar in age, HF etiology, and EF. Hypoalbuminemia was associated with higher New York Heart Association (NYHA) class, higher serum urea nitrogen, creatinine level, C-reactive protein, and B-type natriuretic peptide but lower levels of sodium, hemoglobin, and cholesterol. In patients with BMI |
| doi_str_mv | 10.1016/j.ahj.2007.11.043 |
| format | Article |
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Although low serum albumin is common in patients with heart failure (HF), the relationship between albumin and HF prognosis has not been well characterized. This study investigated the effect of serum albumin level on survival in patients with advanced HF. Methods We analyzed 1726 systolic HF patients (age 52 ± 13 years, ejection fraction [EF] 23% ± 7%) followed at a university HF center. Albumin level was determined at initial referral. Patients were divided by into groups based on presence of hypoalbuminemia (≤3.4 g/dL). Mean albumin was 3.8 ± 0.6 g/dL, and 25% of patients had hypoalbuminemia. Results Patients with and without low albumin levels were similar in age, HF etiology, and EF. Hypoalbuminemia was associated with higher New York Heart Association (NYHA) class, higher serum urea nitrogen, creatinine level, C-reactive protein, and B-type natriuretic peptide but lower levels of sodium, hemoglobin, and cholesterol. In patients with BMI <25 kg/m2 , 27% had albumin ≤3.4 g/dL, compared to 22% of those with BMI ≥25 kg/m2 ( P < .01). One-year survival was 66% in patients with and 83% in those without hypoalbuminemia ( P < .0001). Risk-adjusted hazard ratios for 1- and 5-year mortality were 2.2 (1.4-3.3) and 2.2 (1.4-3.2), respectively. Conclusions Hypoalbuminemia is common in HF and is independently associated with increased risk of death in HF. Further investigation of pathophysiologic mechanisms underlying hypoalbuminemia in HF is warranted.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2007.11.043</identifier><identifier>PMID: 18440336</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Age ; Aged ; Albumins - analysis ; Biological and medical sciences ; Body mass index ; Cardiology. Vascular system ; Cardiovascular ; Cholesterol ; Diabetes ; Enzymes ; Female ; Heart ; Heart failure ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Heart Failure, Systolic - blood ; Heart Failure, Systolic - physiopathology ; Humans ; Hypoalbuminemia - blood ; Hypoalbuminemia - physiopathology ; Kidney diseases ; Male ; Medical prognosis ; Medical sciences ; Middle Aged ; Mortality ; Multivariate analysis ; Predictive Value of Tests ; Risk Factors ; Survival Analysis ; Variables</subject><ispartof>The American heart journal, 2008-05, Vol.155 (5), p.883-889</ispartof><rights>Mosby, Inc.</rights><rights>2008 Mosby, Inc.</rights><rights>2008 INIST-CNRS</rights><rights>Copyright Elsevier Limited May 2008</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c507t-d3fa767bec31bd22e33ee95cc08db8f5376122a99579c983c9c5e946fddada23</citedby><cites>FETCH-LOGICAL-c507t-d3fa767bec31bd22e33ee95cc08db8f5376122a99579c983c9c5e946fddada23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1504597101?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20329543$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18440336$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Horwich, Tamara B., MD, MS</creatorcontrib><creatorcontrib>Kalantar-Zadeh, Kamyar, MD, PhD</creatorcontrib><creatorcontrib>MacLellan, Robb W., MD</creatorcontrib><creatorcontrib>Fonarow, Gregg C., MD, FACC</creatorcontrib><title>Albumin levels predict survival in patients with systolic heart failure</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background Hypoalbuminemia is associated with poor prognosis in patients with certain chronic diseases, such as end-stage renal disease and cancer. Although low serum albumin is common in patients with heart failure (HF), the relationship between albumin and HF prognosis has not been well characterized. This study investigated the effect of serum albumin level on survival in patients with advanced HF. Methods We analyzed 1726 systolic HF patients (age 52 ± 13 years, ejection fraction [EF] 23% ± 7%) followed at a university HF center. Albumin level was determined at initial referral. Patients were divided by into groups based on presence of hypoalbuminemia (≤3.4 g/dL). Mean albumin was 3.8 ± 0.6 g/dL, and 25% of patients had hypoalbuminemia. Results Patients with and without low albumin levels were similar in age, HF etiology, and EF. Hypoalbuminemia was associated with higher New York Heart Association (NYHA) class, higher serum urea nitrogen, creatinine level, C-reactive protein, and B-type natriuretic peptide but lower levels of sodium, hemoglobin, and cholesterol. In patients with BMI <25 kg/m2 , 27% had albumin ≤3.4 g/dL, compared to 22% of those with BMI ≥25 kg/m2 ( P < .01). One-year survival was 66% in patients with and 83% in those without hypoalbuminemia ( P < .0001). Risk-adjusted hazard ratios for 1- and 5-year mortality were 2.2 (1.4-3.3) and 2.2 (1.4-3.2), respectively. Conclusions Hypoalbuminemia is common in HF and is independently associated with increased risk of death in HF. Further investigation of pathophysiologic mechanisms underlying hypoalbuminemia in HF is warranted.</description><subject>Age</subject><subject>Aged</subject><subject>Albumins - analysis</subject><subject>Biological and medical sciences</subject><subject>Body mass index</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cholesterol</subject><subject>Diabetes</subject><subject>Enzymes</subject><subject>Female</subject><subject>Heart</subject><subject>Heart failure</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Heart Failure, Systolic - blood</subject><subject>Heart Failure, Systolic - physiopathology</subject><subject>Humans</subject><subject>Hypoalbuminemia - blood</subject><subject>Hypoalbuminemia - physiopathology</subject><subject>Kidney diseases</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Predictive Value of Tests</subject><subject>Risk Factors</subject><subject>Survival Analysis</subject><subject>Variables</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kkGL1DAUx4Mo7uzqB_AiBdFb60vSJg2CsCzuKix4cO8hTV6Z1Ew7Ju3IfHtTZ3BhD55CyO__8vLLI-QNhYoCFR-HymyHigHIitIKav6MbCgoWQpZ18_JBgBY2UrgF-QypSFvBWvFS3JB27oGzsWG3F2Hbtn5sQh4wJCKfUTn7VykJR78wYQiH-3N7HGcU_Hbz9siHdM8BW-LLZo4F73xYYn4irzoTUj4-rxekYfbLw83X8v773ffbq7vS9uAnEvHeyOF7NBy2jnGkHNE1VgLrevavuFSUMaMUo1UVrXcKtugqkXvnHGG8Svy4VR2H6dfC6ZZ73yyGIIZcVqSForWlMoVfPcEHKYljrk1TRuoGyWzwUzRE2XjlFLEXu-j35l41BT0qlgPOivWq2JNqc6Kc-btufLS7dA9Js5OM_D-DJhkTeijGa1P_zgGnKnmb6FPJy57x4PHqJPNnm3-gIh21m7y_23j85O0DX70-cKfeMT0-FqdmAb9Y52FdRRAAoXsiP8BsRetdA</recordid><startdate>20080501</startdate><enddate>20080501</enddate><creator>Horwich, Tamara B., MD, MS</creator><creator>Kalantar-Zadeh, Kamyar, MD, PhD</creator><creator>MacLellan, Robb W., MD</creator><creator>Fonarow, Gregg C., MD, FACC</creator><general>Mosby, Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20080501</creationdate><title>Albumin levels predict survival in patients with systolic heart failure</title><author>Horwich, Tamara B., MD, MS ; Kalantar-Zadeh, Kamyar, MD, PhD ; MacLellan, Robb W., MD ; Fonarow, Gregg C., MD, FACC</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c507t-d3fa767bec31bd22e33ee95cc08db8f5376122a99579c983c9c5e946fddada23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Age</topic><topic>Aged</topic><topic>Albumins - analysis</topic><topic>Biological and medical sciences</topic><topic>Body mass index</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cholesterol</topic><topic>Diabetes</topic><topic>Enzymes</topic><topic>Female</topic><topic>Heart</topic><topic>Heart failure</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Heart Failure, Systolic - blood</topic><topic>Heart Failure, Systolic - physiopathology</topic><topic>Humans</topic><topic>Hypoalbuminemia - blood</topic><topic>Hypoalbuminemia - physiopathology</topic><topic>Kidney diseases</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Predictive Value of Tests</topic><topic>Risk Factors</topic><topic>Survival Analysis</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Horwich, Tamara B., MD, MS</creatorcontrib><creatorcontrib>Kalantar-Zadeh, Kamyar, MD, PhD</creatorcontrib><creatorcontrib>MacLellan, Robb W., MD</creatorcontrib><creatorcontrib>Fonarow, Gregg C., MD, FACC</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Horwich, Tamara B., MD, MS</au><au>Kalantar-Zadeh, Kamyar, MD, PhD</au><au>MacLellan, Robb W., MD</au><au>Fonarow, Gregg C., MD, FACC</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Albumin levels predict survival in patients with systolic heart failure</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2008-05-01</date><risdate>2008</risdate><volume>155</volume><issue>5</issue><spage>883</spage><epage>889</epage><pages>883-889</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Background Hypoalbuminemia is associated with poor prognosis in patients with certain chronic diseases, such as end-stage renal disease and cancer. Although low serum albumin is common in patients with heart failure (HF), the relationship between albumin and HF prognosis has not been well characterized. This study investigated the effect of serum albumin level on survival in patients with advanced HF. Methods We analyzed 1726 systolic HF patients (age 52 ± 13 years, ejection fraction [EF] 23% ± 7%) followed at a university HF center. Albumin level was determined at initial referral. Patients were divided by into groups based on presence of hypoalbuminemia (≤3.4 g/dL). Mean albumin was 3.8 ± 0.6 g/dL, and 25% of patients had hypoalbuminemia. Results Patients with and without low albumin levels were similar in age, HF etiology, and EF. Hypoalbuminemia was associated with higher New York Heart Association (NYHA) class, higher serum urea nitrogen, creatinine level, C-reactive protein, and B-type natriuretic peptide but lower levels of sodium, hemoglobin, and cholesterol. In patients with BMI <25 kg/m2 , 27% had albumin ≤3.4 g/dL, compared to 22% of those with BMI ≥25 kg/m2 ( P < .01). One-year survival was 66% in patients with and 83% in those without hypoalbuminemia ( P < .0001). Risk-adjusted hazard ratios for 1- and 5-year mortality were 2.2 (1.4-3.3) and 2.2 (1.4-3.2), respectively. Conclusions Hypoalbuminemia is common in HF and is independently associated with increased risk of death in HF. Further investigation of pathophysiologic mechanisms underlying hypoalbuminemia in HF is warranted.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>18440336</pmid><doi>10.1016/j.ahj.2007.11.043</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Age Aged Albumins - analysis Biological and medical sciences Body mass index Cardiology. Vascular system Cardiovascular Cholesterol Diabetes Enzymes Female Heart Heart failure Heart failure, cardiogenic pulmonary edema, cardiac enlargement Heart Failure, Systolic - blood Heart Failure, Systolic - physiopathology Humans Hypoalbuminemia - blood Hypoalbuminemia - physiopathology Kidney diseases Male Medical prognosis Medical sciences Middle Aged Mortality Multivariate analysis Predictive Value of Tests Risk Factors Survival Analysis Variables |
| title | Albumin levels predict survival in patients with systolic heart failure |
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