Relationship Between Serum Albumin Level and Long-term Prognosis in Elderly Patients with Heart Failure
Author:
Affiliation:

Department of Cadre, the Fourth People’s Hospital of Shenyang, Shenyang, Liaoning 110031, China)

Clc Number:

R5

  • Article
  • | |
  • Metrics
  • |
  • Reference [19]
  • | | | |
  • Comments
    Abstract:

    Aim To investigate the relationship between serum albumin level and long-term prognosis in elderly patients with heart failure and analyze the risk factors of hypoalbuminemia in patients with heart failure. Methods 1048 consecutive elderly patients with heart failure were enrolled, and divided into two groups according to serum albumin concentration:hypoalbuminemia group (serum albumin <35 g/L) and normoalbuminemia group (serum albumin ≥35 g/L). Risk factors associated with hypoalbuminemia were analyzed by binary Logistic regression analysis. The primary end point was all cause long-term mortality. COX proportional-hazards regression modeling was used to evaluate the prognostic value of serum albumin for long-term mortality in elderly patients with heart failure. Results Hypoalbuminemia group had higher age, rate of male, NYHA status, direct bilirubin, creatinine, brain natriuretic peptite and C-reactive protein, lower hemoglobin, total cholesterol and serum sodium on admission. Binary Logistic regression analysis revealed that higher NYHA class, higher age, higher brain natriuretic peptite, lower serum sodium, lower total cholesterol and lower hemoglobin were independent risk factors for hypoalbuminemia. The mean follow-up was 20±18 months in 1048 patients. During the follow-up period, 306 patients died, and the mortality was 29.2%. 116 patients died in hypoalbuminemia group, the mortality was 37.7%. 190 patients died in normoalbuminemia group, the mortality was 25.7%. The multivariate COX regression analysis indicated that when albumin decreased by every 1g/L, the risk of long-term death in elderly patients with heart failure increased 3.8% (HR was 1.8,5%CI was 1.007~1.070, P=0.015), hypoalbuminemia group was associated with a 0.296-fold greater risk of long-term death than normoalbuminemia group (HR was 1.6,5%CI was 1.019~1.648, P=0.035). Conclusions Serum albumin was an independent risk factor for long-term mortality in elderly patients with heart failure. Multifactors were significantly associated with hypoalbuminemia.

    Reference
    [1] Roger VL, Weston SA, Redfield MM, et al.Trends in heart failure incidence and survival in a community-based population.JAMA, 4,2 (3):344-350.
    [2] Bonilla-Palomas JL, Gámez-López AL, Moreno-Conde M, et al.Hypoalbuminemia in acute heart failure patients:causes and its impact on hospital and long-term mortality.J Card Fail, 4,0 (5):350-358.
    [3] Wrigley BJ, Lip GY, Shantsila E.The role of monocytes and inflammation in the pathophysiology of heart failure.Eur J Heart Fail, 1,3 (11):1 161-171.
    [4] Adlbrecht C, Kommata S, Hülsmann M, et al.Chronic heart failure leads to an expanded plasma volume and pseudoanaemia, but does not lead to a reduction in the body's red cell volume.Eur Heart J, 8,9 (19):2 343-350.
    [5] Zamora E, Lupón J, Vila J, et al.Estimated glomerular filtration rate and prognosis in heart failure:value of the Modification of Diet in Renal Disease Study-4, chronic kidney disease epidemiology collaboration, and cockroft-gault formulas.J Am Coll Cardiol, 2,9 (19):1 709-715.
    [6] Herzer K, Kneiseler G, Bechmann LP, et al.Onset of heart failure determines the hepatic cell death pattern.Ann Hepatol, 1,0 (2):174-179.
    [7] Arques S, Ambrosi P.Human serum albumin in the clinical syndrome of heart failure.J Card Fail, 1,7 (6):451-458.
    [8] Eising GP, Niemeyer M, Günther T, et al.Does a hyperoncotic cardiopulmonary bypass prime affect extravascular lung water and cardiopulmonary function in patients undergoing coronary artery bypass surgery.Eur J Cardiothorac Surg, 1,0 (2):282-289.
    [9] Gheorghiade M, Shin DD, Thomas TO, et al.Congestion is an important diagnostic and therapeutic target in heart failure.Rev Cardiovasc Med, 6,7 (Suppl 1):S 12-24.
    [10] Su W, An T, Zhou Q, et al.Serum albumin is a useful prognostic indicator and adds important information to NT-proBNP in a Chinese cohort of heart failure.Clin Biochem, 2,5 (7-8):561-565.
    [11] Arques S, Roux E, Stolidi P, et al.Usefulness of serum albumin and serum total cholesterol in the prediction of hospital death in older patients with severe, acute heart failure.Arch Cardiovasc Dis, 1,4 (10):502-508.
    [12] Kinugasa Y, Kato M, Sugihara S, et al.A simple risk score to predict in-hospital death of elderly patients with acute decompensated heart failure-hypoalbuminemia as an additional prognostic factor.Circ J, 9,3 (12):2 276-281.
    [13] Arques S, Roux E, Sbragia P, et al.Usefulness of serum albumin concentration for in-hospital risk stratification in frail, elderly patients with acute heart failure.Insights from a prospective, monocenter study.Int J Cardiol, 8,5 (2):265-267.
    [14] 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2014.中华心血管病杂志, 4,2:98-122.
    [15] Chojkier M.Inhibition of albumin synthesis in chronic diseases:molecular mechanisms.J Clin Gastroenterol, 5,9 (4 Suppl 2):S 143-146.
    [16] Battin DL, Ali S, Shahbaz AU, et al.Hypoalbuminemia and lymphocytopenia in patients with decompensated biventricular failure.Am J Med Sci, 0,9 (1):31-35.
    [17] Levy D, Kenchaiah S, Larson MG, et al.Long-term trends in the incidence of and survival with heart failure.N Engl J Med, 2,7 (18):1 397-402.
    [18] Bleumink GS, Knetsch AM, Sturkenboom MC, et al.Quantifying the heart failure epidemic:prevalence, incidence rate, lifetime risk and prognosis of heart failure.The Rotterdam Study.Eur Heart J, 4,5 (18):1 614-619.
    [19] Zoellner H, Hfler M, Beckmann R, et al.Serum albumin is a specific inhibitor of apoptosis in human endothelial cells.J Cell Sci, 6,9 (Pt 10):2 571-580.
    Related
    Cited by
    Comments
    Comments
    分享到微博
    Submit
Get Citation

REN Xiao-Hong, JIN Li, LI Yu-Rong, FANG Hui-Juan, CUI Dong-Qin, QU Wei. Relationship Between Serum Albumin Level and Long-term Prognosis in Elderly Patients with Heart Failure[J]. Editorial Office of Chinese Journal of Arteriosclerosis,2016,24(8):812-816.

Copy
Share
Article Metrics
  • Abstract:
  • PDF:
  • HTML:
  • Cited by:
History
  • Received:November 09,2015
  • Revised:January 18,2016
  • Online: July 25,2016
Article QR Code