Low prealbumin is strongly associated with adverse outcome in heart failure

• Type: Article in International Scientific Journal
• Date: 2014

Authors

Lourenço, P (Author) Other; Silva, S (Author) Other; Friões, F (Author) FMUP; Alvelos, M (Author) Other; Amorim, M (Author) Other; Couto, M (Author) Other; Torres-Ramalho, P (Author) FMUP; Guimarães, JT (Author) FMUP; Araujo, JP (Author) FMUP; Bettencourt, P (Author) FMUP

Journal

Title: Heart

Vol. 100

Pages: 1780-1785

ISSN: 1355-6037

Publisher: BMJ PUBLISHING GROUP

Indexing

ISI Web of Knowledge - 41 Citations

Scopus - 45 Citations

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Authenticus ID: P-00A-0ZE

DOI: 10.1136/heartjnl-2014-305747

Abstract (EN): Objective Prealbumin is one of the best indicators of nutritional status. We previously showed that prealbumin predicted in-hospital mortality in heart failure (HF) patients. We evaluated if a low discharge prealbumin after admission with acute HF would predict morbidity and mortality. Methods We conducted a prospective observational study. Patients admitted with a primary diagnosis of HF were studied. Follow-up was up to 6 months. Endpoints analysed were: all-cause and HF-death; all-cause and worsening HF hospitalisation. Patients with discharge prealbumin <= 15.0 mg/dL and those with prealbumin >15 mg/dL were compared. A Cox-regression analysis was used to evaluate the prognostic impact of low prealbumin. Results We studied 514 patients. Mean age was 78 years and 45.7% were male. During follow-up, 101 patients died (78 for HF) and 209 patients were hospital readmitted (140 for worsening HF). Median prealbumin was 20.1 (15.3-25.3) mg/dL. Patients with lower prealbumin were more often women, older aged and with non-ischaemic HF; they had lower albumin, haemoglobin and total cholesterol; and higher glomerular filtration rate, C-reactive protein, B-type natriuretic peptide and length of hospital stay. Lower prealbumin associated with less beta-blocker and statin use. Patients with discharge prealbumin <= 15 mg/dL had a multivariate adjusted HR of 6-month all-cause and HF death of 1.67 (1.00 to 2.80) and 2.12 (1.19 to 3.79) respectively and of all-cause and HF readmission of 1.47 (1.01 to 2.14) and 1.58 (1.01 to 2.47). Conclusions Patients with discharge prealbumin <= 15 mg/dL have an higher risk of 6 months morbidity and mortality. The unbalance between protein-energy demands and its availability predicts ominous HF outcome.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 6