Hypoalbuminemia as a predictor of worst functional capacity recovery in patients attending cardiac rehabilitation after ACS

• Type: Summary of Presentation in an International Conference
• Date: 2012

Authors

Sousa C (Author) Other; Rocha A (Author) Other; Rangel I (Author) Other; Correia AS (Author) Other; Paiva M (Author) Other; Gonçalves A (Author) Other; Araújo V (Author) Other; Parada Pereira F (Author) Other; Maciel MJ (Author) FMUP

Conference proceedings International

Title: European Journal of Heart Failure Supplements

Initial page: P1087

Heart Failure Congress 2012

Belgrade, 2012

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Abstract (EN): Background: Hypoalbuminemia is a negative acute phase protein and a marker of poor prognosis in heart failure and acute coronary syndrome (ACS). There are no data addressing the relation between hypoalbuminemia and functional capacity (FC). This study aimed to evaluate the effect of admission serum albumin on the improvement of FC in ACS patients undergoing a cardiac rehabilitation program (CRP), as well as to access the prognostic impact of hypoalbumin in this population. Methods: 249 consecutive patients were enrolled. Admission serum albumin measurements were collected. FC was measured in metabolic equivalents (METS) achieved during the initial and the final exercise sessions of the CRP. Improvement in FC was evaluated through the METS difference. Post-discharge follow-up was performed to determine the occurrence of a composite outcome (all cause mortality and new hospital admission for ACS, stroke and congestive heart failure). Results: 222 (89.2%) patients were male and mean age was 53.9±9.9 years. Mean serum albumin was 39.2±7.5 and 56 (22.5%) patients had hypoalbuminemia (≤37mg/dL). Patients with hypoalbuminemia were older (56.7±10.4% vs. 52.9±9.6%, p=0.012), more often women (19.6% vs. 7.9%, p=0.014) and diabetic (30.4% vs. 16.5%, p=0.023). There were no differences in other cardiovascular risk factors prevalence, admission diagnosis, left ventricular systolic function and severity of the coronary disease. Hypoalbuminemic patients had lower hemoglobin (13.2±2.3 vs. 14.5±1.3 g/dL, p=0.0001) and higher maximum BNP level (294.5±298.2 vs. 155.6±159.9 pg/mL, p=0.0001). After the CRP, FC improved significantly in both groups: from 5.1±1.4 METS to 8.3±2.0 METS (p=0.0001) in hypoalbuminemia group, and from 5.6±1.4 to 9.5±1.8 METS (p=0.0001) in normoalbuminemia group. However, the degree of improvement was lower in the hypoalbumin group (3.2±1.9 METS vs.3.8±1.6 METS, p=0.033). Follow-up was possible in 235 (94.4%) patients, for a mean time 24.4±8.3 months. Composite outcome occurred in 23 (9.2%) patients at a mean time of 11.4±8.6 months. After Cox-regression multivariate analysis, adjusted for relevant covariates, hypoalbuminemia was a strong and independent predictor of the composite outcome (HR 5.6, CI 2.0-16.0). Conclusions: Admission hypoalbuminemia associates with poorer FC recovery and worse outcome in ACS undergoing CRP. A new, inexpensive, functional and prognostic marker might have been found.

Language: English

Type (Professor's evaluation): Scientific

Notes: Sousa C. Rocha A, Rangel I, Correia AS, Paiva M, Ribeiro V, Melão F, Gonçalves A, Araújo V, Parada F, Maciel MJ. Hypoalbuminemia as a predictor of worst functional capacity recovery in patients attending cardiac rehabilitation after ACS. Eur J Heart Fail Suppl 2012; 11(Suppl 1): P1087. ISSN 1567-4215. Heart Failure Congress 2012, Belgrade, 2012