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

被引:46
作者
Grodin, Justin L. [1 ]
Lala, Anuradha [2 ,3 ]
Stevens, Susanna R. [4 ]
DeVore, Adam D. [4 ,5 ]
Cooper, Lauren B. [4 ,5 ]
AbouEzzeddine, Omar F. [6 ]
Mentz, Robert J. [4 ,5 ]
Groarke, John D. [2 ]
Joyce, Emer [2 ]
Rosenthal, Julie L. [1 ]
Vader, Justin M. [7 ]
Tang, W. H. Wilson [1 ]
机构
[1] Cleveland Clin, Inst Heart & Vasc, Dept Cardiovasc Med, Cleveland, OH 44106 USA
[2] Brigham & Womens Hosp, Dept Adv Heart Dis, 75 Francis St, Boston, MA 02115 USA
[3] Mt Sinai Med Ctr, Zena & Michael A Wiener Cardiovasc Inst, New York, NY 10029 USA
[4] Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA
[5] Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA
[6] Mayo Clin, Div Cardiol, Dept Med, Rochester, MN USA
[7] Washington Univ, Sch Med, Dept Med, Div Cardiol, St Louis, MO 63110 USA
关键词
Heart failure; proteins; diuretics; FUROSEMIDE; MORTALITY; PROTEIN; RESISTANCE; KIDNEY;
D O I
10.1016/j.cardfail.2016.01.015
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Hypoalbuminemia is common in patients with chronic heart failure and, as a marker of disease severity, is associated with an adverse prognosis. Whether hypoalbuminemia contributes to (or is associated with) worse outcomes in acute heart failure (AHF) is unclear. We sought to determine the implications of low serum albumin in patients receiving decongestive therapies for AHF. Methods and Results: Baseline serum albumin levels were measured in 456 AHF subjects randomized in the DOSE-AHF and ROSE-AHF trials. We assessed the relationship between admission albumin levels (both as a continuous variable and stratified by median albumin [>= 3.5 g/dL]) and worsening renal function (WRF), worsening heart failure (WHF), and clinical decongestion by 72 hours; 7-day cardiorenal biomarkers; and post-discharge outcomes. The mean baseline albumin level was 3.5 +/- 0.5 g/dL. Albumin was not associated with WRF, WHF, or clinical decongestion by 72 hours. Furthermore, there was no association between continuous albumin levels and symptom change according to visual analog scale or weight change by 72 hours. Albumin was not associated with 60-day mortality, rehospitalization, or unscheduled emergency room visits. Conclusions: Baseline serum albumin levels were not associated with short-term clinical outcomes for AHF patients undergoing decongestive therapies. These data suggest that serum albumin may not be a helpful tool to guide decongestion strategies.
引用
收藏
页码:884 / 890
页数:7
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