Association of an increase in serum albumin levels with positive 1-year outcomes in acute decompensated heart failure: A cohort study

被引：24

作者：

Kato, Takao ^{[1
]}

Yaku, Hidenori ^{[1
]}

Morimoto, Takeshi ^{[2
]}

Inuzuka, Yasutaka ^{[3
]}

Tamaki, Yodo ^{[4
]}

Ozasa, Neiko ^{[1
]}

Yamamoto, Erika ^{[1
]}

Yoshikawa, Yusuke ^{[1
]}

Kitai, Takeshi ^{[5
]}

Taniguchi, Ryoji ^{[6
]}

Iguchi, Moritake ^{[7
]}

Kato, Masashi ^{[8
]}

Takahashi, Mamoru ^{[9
]}

Jinnai, Toshikazu ^{[10
]}

Ikeda, Tomoyuki ^{[11
]}

Nagao, Kazuya ^{[12
]}

Kawai, Takafumi ^{[13
]}

Komasa, Akihiro ^{[14
]}

Nishikawa, Ryusuke ^{[15
]}

Kawase, Yuichi ^{[16
]}

Morinaga, Takashi ^{[17
]}

Kawato, Mitsunori ^{[18
]}

Seko, Yuta ^{[19
]}

Shiba, Masayuki ^{[1
]}

Toyofuku, Mamoru ^{[20
]}

Furukawa, Yutaka ^{[5
]}

Ando, Kenji ^{[17
]}

Kadota, Kazushige ^{[16
]}

Sato, Yukihito ^{[6
]}

Kuwahara, Koichiro ^{[21
]}

Kimura, Takeshi ^{[1
]}

机构：

[1] Kyoto Univ, Grad Sch Med, Dept Cardiovasc Med, Kyoto, Japan

[2] Hyogo Coll Med, Dept Clin Epidemiol, Nishinomiya, Hyogo, Japan

[3] Shiga Gen Hosp, Dept Cardiovasc Med, Shiga, Japan

[4] Tenri Hosp, Div Cardiol, Nara, Japan

[5] Kobe City Med Ctr Gen Hosp, Dept Cardiovasc Med, Kobe, Hyogo, Japan

[6] Hyogo Prefectural Amagasaki Gen Med Ctr, Dept Cardiol, Amagasaki, Hyogo, Japan

[7] Natl Hosp Org Kyoto Med Ctr, Dept Cardiol, Kyoto, Japan

[8] Mitsubishi Kyoto Hosp, Dept Cardiol, Kyoto, Japan

[9] Shimabara Hosp, Dept Cardiol, Kyoto, Japan

[10] Japanese Red Cross Otsu Hosp, Dept Cardiol, Shiga, Japan

[11] Hikone Municipal Hosp, Dept Cardiol, Shiga, Japan

[12] Osaka Red Cross Hosp, Dept Cardiol, Osaka, Japan

[13] Kishiwada City Hosp, Dept Cardiol, Osaka, Japan

[14] Kansai Elect Power Hosp, Dept Cardiol, Osaka, Japan

[15] Shizuoka Prefectural Gen Hosp, Dept Cardiol, Shizuoka, Japan

[16] Kurashiki Cent Hosp, Dept Cardiol, Okayama, Japan

[17] Kokura Mem Hosp, Dept Cardiol, Fukuoka, Japan

[18] Kobe City Nishi Kobe Med Ctr, Dept Cardiol, Kobe, Hyogo, Japan

[19] Kitano Hosp, Osaka, Japan

[20] Japanese Red Cross Wakayama Med Ctr, Dept Cardiol, Wakayama, Japan

[21] Shinshu Univ, Grad Sch Med, Dept Cardiovasc Med, Matsumoto, Nagano, Japan

来源：

PLOS ONE | 2020年 / 15卷 / 12期

关键词：

CHAIN AMINO-ACIDS; HYPOALBUMINEMIA;

D O I：

10.1371/journal.pone.0243818

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Background Despite the prognostic importance of hypoalbuminemia, the prognostic implication of a change in albumin levels has not been fully investigated during hospitalization in patients with acute decompensated heart failure (ADHF). Methods Using the data from the Kyoto Congestive Heart Failure registry on 3160 patients who were discharged alive for acute heart failure hospitalization and in whom the change in albumin levels was calculated at discharge, we evaluated the association with an increase in serum albumin levels from admission to discharge and clinical outcomes by a multivariable Cox hazard model. The primary outcome measure was a composite of all-cause death or hospitalization for heart failure. Findings Patients with increased albumin levels (N = 1083, 34.3%) were younger and less often had smaller body mass index and renal dysfunction than those with no increase in albumin levels (N = 2077, 65.7%). Median follow-up was 475 days with a 96% 1-year follow-up rate. Relative to the group with no increase in albumin levels, the lower risk of the increased albumin group remained significant for the primary outcome measure (hazard ratio: 0.78, 95% confidence interval: 0.69-0.90: P = 0.0004) after adjusting for confounders including baseline albumin levels. When stratified by the quartiles of baseline albumin levels, the favorable effect of increased albumin was more pronounced in the lower quartiles of albumin levels, but without a significant interaction effect (interaction P = 0.49). Conclusions Independent of baseline albumin levels, an increase in albumin during index hospitalization was associated with a lower 1-year risk for a composite of all-cause death and hospitalization in patients with acute heart failure.

引用

页数：13

共 22 条

[1] Liver function abnormalities and outcome in patients with chronic heart failure: data from the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) program [J].