Clinical Implications of Serum Albumin Levels in Acute Heart Failure: Insights from DOSE-AHF and ROSE-AHF

Highlights • Binding of albumin to diuretics are key to delivery to the nephron, and low albumin levels diminish intravascular oncotic pressures necessary to maintain intravascular volume for effective diuresis. • Based on prospectively collected data from two acute heart failure clinical trials (DO...

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Veröffentlicht in:	Journal of cardiac failure 2016-11, Vol.22 (11), p.884-890
Hauptverfasser:	Grodin, Justin L., MD, Lala, Anuradha, MD, Stevens, Susanna R., MS, DeVore, Adam D., MD, Cooper, Lauren B., MD, AbouEzzedine, Omar F., MD CM, Mentz, Robert J., MD, Groarke, John D., MBBCh MPH, Joyce, Emer, MBBCh, Rosenthal, Julie L., MD, Vader, Justin M., MD, Tang, W.H. Wilson, MD
Format:	Artikel
Sprache:	eng
Schlagworte:	Acute Disease Aged Biomarkers - blood Cardiovascular Cause of Death Chi-Square Distribution diuretics Diuretics - therapeutic use Double-Blind Method Female Heart failure Heart Failure - blood Heart Failure - drug therapy Heart Failure - mortality Heart Failure - physiopathology Hospital Mortality Humans Kidney Function Tests Logistic Models Male Middle Aged Prognosis Proportional Hazards Models Prospective Studies proteins Randomized Controlled Trials as Topic Renal Insufficiency - drug therapy Renal Insufficiency - mortality Renal Insufficiency - physiopathology Risk Assessment Serum Albumin - analysis Severity of Illness Index Survival Analysis United States
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Zusammenfassung:	Highlights • Binding of albumin to diuretics are key to delivery to the nephron, and low albumin levels diminish intravascular oncotic pressures necessary to maintain intravascular volume for effective diuresis. • Based on prospectively collected data from two acute heart failure clinical trials (DOSE-AHF and ROSE-AHF), this may not be the case in acute heart failure populations largely free of nephrotic syndrome or cirrhosis. • Our data from two well characterized cohorts of patients with acute heart failure suggested serum albumin may not be a helpful tool to guide decongestion strategies or determine effectiveness of therapy.
ISSN:	1071-9164 1532-8414
DOI:	10.1016/j.cardfail.2016.01.015