010 Multicentre validation of the adverse prognostic implications of declining serum albumin levels in chronic heart failure
| Autor: | Resham Baruah, DP Francis, Anthony J. Barron, Richard J. Jabbour, Charlotte Manisty, Nay Aung, Martin Thomas, Syed Husain, Simon Woldman, Graham D. Cole, Do okonko, Jamil Mayet, Nabeela Zaman, Hua Zen Ling |
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| Rok vydání: | 2012 |
| Předmět: | |
| Zdroj: | Heart. 98:A9.1-A9 |
| ISSN: | 1468-201X 1355-6037 |
| Popis: | Background Single-centre studies have shown that a low serum albumin at baseline forecasts enhanced mortality in chronic heart failure (CHF) possibly because it reflects aberrations (eg, inflammation, impaired nutrition, plasma volume expansion) that can exacerbate disease. We hypothesised that attenuations in serum albumin over time would be prognostically more ominous than baseline values, and would be so even in a multicentre setting. Methods We analysed the survival implications of baseline albumin and ∆albumin in a derivation cohort of 246 CHF outpatients (mean [±SD] age 68±12 years, LVEF 29±8%, 48% NYHA class >2) from University College London Hospital and then in a validation cohort of 148 CHF outpatients (age 69±12 years, LVEF 28±10%, 41% NYHA class >2) from Imperial Healthcare (St Marys Hospital and Hammersmith Hospital, London). Results In the derivation cohort, 51 (21%) patients died over 13 months. Baseline albumin independently predicted mortality (HR 0.89, 95% CI 0.84 to 0.94, χ 2 :18, p 2 :53, p 6 g/l optimally predicted death (ROC AUC 0.82, p 2 value (43 vs 84, p 2 : 44, p 6 g/l predicting an ∼sixfold increased risk (HR 5.64, 95% CI 3.08 to 10.31, χ 2 : 35, p 2 value (51 vs 65, p Conclusions A fall in serum albumin over time consistently predicts an amplified risk of death in systolic CHF and enables simple and cheap risk stratification. |
| Databáze: | OpenAIRE |
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