Association of admission vs. nadir serum albumin concentration with short-term treatment outcomes in patients with acute heart failure

Objectives Hypoalbuminemia occurs in 25% to 76% of patients hospitalized for acute heart failure (HF) and is associated with increased mortality. Hypoalbuminemia may predispose patients to intravascular volume depletion, hypotension, and acute worsening of renal function; however, its association with treatment outcomes during hospitalization is unknown. Methods This retrospective cohort study involved 414 adult patients hospitalized for HF requiring intravenous diuretics. Temporal changes in serum albumin and the association of hypoalbuminemia with urine output, renal function changes, blood pressure, use of intravenous vasoactive drugs, and short-term outcomes were assessed. Results Serum albumin decreased in most patients (72%) during hospitalization. Hypoalbuminemia was present in 29% and 50% of patients based on the mean admission and nadir serum albumin level, respectively. Hypoalbuminemia as assessed by the nadir albumin level was associated with an increased risk of acute worsening of renal function. A nadir albumin level of <3.0 g/dL remained significantly associated in the multivariate analyses. Conclusions Serum albumin commonly decreases during hospitalization for acute HF. Hypoalbuminemia assessed using the nadir level during hospitalization, not the admission level, was associated with an increased risk of acute worsening of renal function. The timing of serum albumin measurement may influence its utility as a biomarker.

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Nadir, Not Admission, Serum Albumin Is Associated with Increased Risk of Acute Worsening of Renal Function in Acute Heart Failure

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2013.06.027 ◽

2013 ◽

Vol 19 (8) ◽

pp. S9

Author(s):

Tien M.H. Ng ◽

Evan J. Peterson ◽

Komal A. Patel ◽

Mimi Lou ◽

Grace Huang ◽

...

Keyword(s):

Heart Failure ◽

Renal Function ◽

Serum Albumin ◽

Acute Heart Failure ◽

Increased Risk

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Comparative Assessment of Short-Term Adverse Events in Acute Heart Failure With Cystatin C and Other Estimates of Renal Function

JACC Heart Failure ◽

10.1016/j.jchf.2014.06.014 ◽

2015 ◽

Vol 3 (1) ◽

pp. 40-49 ◽

Cited By ~ 25

Author(s):

W.H. Wilson Tang ◽

Matthias Dupont ◽

Adrian F. Hernandez ◽

Adriaan A. Voors ◽

Amy P. Hsu ◽

...

Keyword(s):

Heart Failure ◽

Renal Function ◽

Adverse Events ◽

Acute Heart Failure ◽

Cystatin C ◽

Comparative Assessment ◽

Short Term

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Angiopoietin-Like Protein 7 and Short-Term Mortality in Acute Heart Failure

Cardiorenal Medicine ◽

10.1159/000504879 ◽

2020 ◽

Vol 10 (2) ◽

pp. 116-124 ◽

Cited By ~ 1

Author(s):

Chongyu Zhang ◽

Xin He ◽

Jingjing Zhao ◽

Yalin Cao ◽

Jian Liu ◽

...

Keyword(s):

Heart Failure ◽

Acute Heart Failure ◽

Inflammatory Responses ◽

Statistical Significance ◽

Serum Levels ◽

Enzyme Linked Immunosorbent Assay ◽

Short Term ◽

Logistic Regression Models ◽

Increased Risk ◽

Short Term Mortality

Introduction: Angiopoietin-like protein 7 (ANGPTL7) is involved in extracellular matrix expression and inflammatory responses. However, the prognostic utility of ANGPTL7 among patients with acute heart failure (AHF) remains unclear. Objective: To evaluate the association between ANGPTL7 and short-term mortality due to AHF. Methods and Results: Patients with AHF were prospectively studied. Serum levels of ANGPTL7 were measured by an enzyme-linked immunosorbent assay. Associations between 30- and 90-day mortality and tertiles of ANGPTL7 were assessed by multivariate logistic regression models. The study comprised 142 patients. Median patient age was 68 years, and 69.7% were male. There were 20 deaths within 30 days and 37 deaths within 90 days. Crude rates of 30-day mortality in low, intermediate, and high tertiles of ANGPTL7 were 4.6, 14.6, and 22.9%, respectively. Crude rates of 90-day mortality of corresponding tertiles were 15.2, 25.0, and 37.5%. After adjusting for potential confounders, including NT-proBNP, the high tertile of ANGPTL7 was associated with a significantly increased risk of both 30-day mortality (odds ratio [OR]: 6.77, 95% confidence interval [CI]: 1.41–32.61, p = 0.017) and 90-day mortality (OR: 3.78, 95% CI: 1.38–10.36, p = 0.010) compared with the low tertile of ANGPTL7. Although mortality risk tended to be higher in the intermediate tertile than the low tertile, it did not reach statistical significance (OR: 3.75, 95% CI: 0.73–19.14, p = 0.113 for 30-day mortality; OR: 1.88, 95% CI: 0.66–5.34, p = 0.236 for 90-day mortality). Conclusions: Serum level of ANGPTL7 was independently associated with short-term mortality among patients with AHF.

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Serum albumin level and long-term outcome in acute heart failure

Acta Cardiologica ◽

10.1080/00015385.2018.1521557 ◽

2019 ◽

Vol 74 (6) ◽

pp. 465-471 ◽

Cited By ~ 7

Author(s):

Arnaud Ancion ◽

Sophie Allepaerts ◽

Sébastien Robinet ◽

Cecile Oury ◽

Luc A. Pierard ◽

...

Keyword(s):

Heart Failure ◽

Serum Albumin ◽

Acute Heart Failure ◽

Serum Albumin Level ◽

Albumin Level ◽

Term Outcome ◽

Long Term Outcome

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The association between serum albumin and LOS of patients with acute heart failure: a retrospective study based on the MIMIV-IV database

10.21203/rs.3.rs-850487/v1 ◽

2021 ◽

Author(s):

Tao Liu ◽

haochen xuan ◽

lili wang ◽

xiaoqun li ◽

zhihao lu ◽

...

Keyword(s):

Heart Failure ◽

Intensive Care ◽

Serum Albumin ◽

Acute Heart Failure ◽

Medical Information ◽

Interactive Effect ◽

Albumin Level ◽

Outcome Variable ◽

Trend Test ◽

Exposure Variable

Abstract Objective: To assess the relationship between serum albumin and length of stay (LOS) of the intensive care unit (ICU).Design and Participants: we retrospectively analyze 2280 patients with acute heart failure(AHF) from the medical information mart for intensive care IV (the MIMIC-IV ) database. Materials and Methods: The exposure variable of the present study was serum albumin. The outcome variable was LOS. The final models were established by multivariate linear regression, and subgroup analysis was performed. Trend test and smooth fitting curves were used to evaluate the association between serum albumin and LOS. Results: When the value of serum albumin was less than 5.1g/dl, the analysis of 2280 patients showed that the linear relationship between albumin and LOS. LOS was gradually shortened with the albumin increasing (β: -0.636; 95%CI: -0.819, -0.453; P <0.001). In subgroup, sepsis and serum albumininitial had an interactive effect on LOS (P=0.036), and there was significantly different between AHF patients with sepsis (β:-1.927; 95%CI:-3.823, -0.030) and without sepsis(β: -1.412; 95%CI:-1.737, -1.087) .Conclusion: When serum albumin was less than 5.1g/dl, the negative association was presented between serum albumin level and LOS among patients with AHF, and this association is even closer in patients with sepsis.

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P0157GENETICALLY DETERMINED HYPOALBUMINEMIA AND THE RISK OF HYPERTENSION: GWAS-BASED INSTRUMENTAL VARIABLE ANALYSIS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0157 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Sang-Woong Han ◽

Mi-yeon Yu ◽

Jong Wook Choi ◽

Joo-Hark Yi ◽

Chang Hwa Lee ◽

...

Keyword(s):

Genetic Variation ◽

Serum Albumin ◽

Instrumental Variable ◽

Serum Albumin Level ◽

Albumin Level ◽

Albumin Concentration ◽

Two Stage ◽

Instrumental Variable Analysis ◽

Increased Risk ◽

Variable Analysis

Abstract Background and Aims Hypoalbuminemia is a clinical indicator of vascular endothelial dysfunction. However, the genetic association of hypoalbuminemia with hypertension has not yet been clarified. We investigated whether genetic variation(s) associated with decreased serum albumin level is deeply related with increased risk of hypertension. Method Mild hypoalbuminemia was defined as a serum albumin concentration of less than 4.0 g/dL. We performed GWAS-based instrumental variable analysis using the population-based cohort data collected from KoGES. Eligible as cases were all native Koreans without significant medical illness and a total 4326 participants were divided in into control (n = 3157) and hypoalbuminemic (n = 1168) according to their serum albumin level. Results Our GWAS revealed that 71 susceptibility loci were associated with mild hypoalbuminemia and subsequent two-stage least squares estimation analysis showed that both genetic variations at rs2894536 in LOC107986598 gene and rs10972486 in the ATP8B5P gene were related with systolic blood pressure. In subsequent Cox-proportional hazards model, we found that not only low serum albumin (HR = 0.654, 95% CI = 0.521-0.820), but also polymorphisms of rs2894536 (HR = 1.176, 95% CI = 1.015-1.361) and rs10972486 (HR = 1.152, 95% CI = 1.009-1.316) were significant predictor of hypertension. Our two-stage residual inclusion analysis indicated that candidate genetic variation attenuated the association between serum albumin and hypertension, showing hazard ratios of hypoalbuminemia on development of hypertension were 0.762 (0.659-0.882) for rs2894536 and 0.759 (0.656-0.878) for rs10972486. Conclusion These findings support a causal relationship between hypoalbuminemia-associated genetic variation, hypoalbuminemia and development of hypertension.

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Worsening Renal Function in Patients Hospitalized with Acute Heart Failure: Risk Factors and Prognostic Significances

International Journal of Nephrology ◽

10.4061/2011/785974 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Valerio Verdiani ◽

Vieri Lastrucci ◽

Carlo Nozzoli

Keyword(s):

Heart Failure ◽

Renal Function ◽

Acute Heart Failure ◽

Hospital Length ◽

Hospitalized Patients ◽

Hospital Length Of Stay ◽

Clinical Predictors ◽

Worsening Renal Function ◽

Increased Risk ◽

History Of

Objectives. To determine the prevalence, the clinical predictors, and the prognostic significances of Worsening Renal Function (WRF) in hospitalized patients with Acute Heart Failure (AHF).Methods. 394 consecutively hospitalized patients with AHF were evaluated. WRF was defined as an increase in serum creatinine of mg/dL from baseline to discharge.Results. Nearly 11% of patients developed WRF. The independent predictors of WRF analyzed with a multivariable logistic regression were history of chronic kidney disease (), age 75 years (), and admission heart rates bpm (). Mortality or rehospitalization rates at 1 month, 6 months, and 1year were not significantly different between patients with WRF and those without WRF.Conclusion. Different clinical predictors at hospital admission can be used to identify patients at increased risk for developing WRF. Patients with WRF compared with those without WRF experienced no significant differences in hospital length of stay, mortality, or rehospitalization rates.

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