PMID- 18440336
OWN - NLM
STAT- MEDLINE
DCOM- 20080527
LR  - 20220408
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 155
IP  - 5
DP  - 2008 May
TI  - Albumin levels predict survival in patients with systolic heart failure.
PG  - 883-9
LID - 10.1016/j.ahj.2007.11.043 [doi]
AB  - 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 (< or = 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/m(2), 27% had albumin < or = 3.4 g/dL, 
      compared to 22% of those with BMI > or = 25 kg/m(2) (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.
FAU - Horwich, Tamara B
AU  - Horwich TB
AD  - Ahmanson-University of California Los Angeles Cardiomyopathy Center, UCLA Medical 
      Center, Los Angeles, CA 90095-1679, USA. thorwich@mednet.ucla.edu
FAU - Kalantar-Zadeh, Kamyar
AU  - Kalantar-Zadeh K
FAU - MacLellan, Robb W
AU  - MacLellan RW
FAU - Fonarow, Gregg C
AU  - Fonarow GC
LA  - eng
GR  - R01 DK078106/DK/NIDDK NIH HHS/United States
GR  - R01 DK078106-01/DK/NIDDK NIH HHS/United States
GR  - 1K23HL085097/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20080130
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
RN  - 0 (Albumins)
SB  - IM
MH  - Aged
MH  - Albumins/*analysis
MH  - Female
MH  - Heart Failure, Systolic/*blood/physiopathology
MH  - Humans
MH  - Hypoalbuminemia/*blood/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Risk Factors
MH  - Survival Analysis
EDAT- 2008/04/29 09:00
MHDA- 2008/05/28 09:00
CRDT- 2008/04/29 09:00
PHST- 2007/08/27 00:00 [received]
PHST- 2007/11/30 00:00 [accepted]
PHST- 2008/04/29 09:00 [pubmed]
PHST- 2008/05/28 09:00 [medline]
PHST- 2008/04/29 09:00 [entrez]
AID - S0002-8703(07)01041-1 [pii]
AID - 10.1016/j.ahj.2007.11.043 [doi]
PST - ppublish
SO  - Am Heart J. 2008 May;155(5):883-9. doi: 10.1016/j.ahj.2007.11.043. Epub 2008 Jan 
      30.