Application of the ALBI Scoring System for Mortality Outcome Prediction in Patients with Hypertrophic Cardiomyopathy

Abstract

Background: There is no information about the clinical significance of the albuminbilirubin (ALBI) score in patients with hypertrophic cardiomyopathy (HCM). Objective:We retrospectively performed clinical evaluations in 462 patients with HCM to estimate whether the ALBI score could be a new tool to predict mortality in HCM. Methods and Results:During a median follow-up of 4.7 years, HCM-related death occurred in 52 (11.3%) patients. Overall, there was a significant positive association between ALBI score and HCM-related death (adjusted hazard ratio [HR]: 1.79 per one standard deviation [SD] increment, 95% confidence interval [CI]: 1.36-2.35). When the score was assessed as tertiles, the adjusted HRs of HCM-related death were 1.30 (95% CI: 0.42-3.99) for the tertile 2 and 4.43 (95% CI: 1.65-11.89) for the tertile 3, compared with the tertile 1. Stratified analysis and E-value analysis suggested the robustness of the above-mentioned results. Meanwhile, time-dependent ROC analysis showed ALBI score could discriminate HCM-related death at various time points (AUC ranges: 0.725-0.850). Furthermore, exploratory analysis indicated the dynamic changes of ALBI score also could predict HCM-related death. Finally, multiple linear regression analysis suggested some pathogenetic pathways associated with HCM-related adverse outcomes significantly correlated with ALBI score, and the pathways included inflammation, myocardial injury, nutritional status and some clinical characteristics, but not abnormal cardiac structure and function itself. Conclusions:Higher ALBI score is a strong independent predictor of HCM-related death in patients with HCM. 2 Qiao et al.

Influence of Nutritional Parameters on the Evolution, Severity and Prognosis of Critically Ill Patients with COVID-19

“…Decreased albumin levels are associated with an increased risk of acute respiratory failure and increased frequency of mechanical ventilation [53]. An association of albumin with mortality was also found in other studies; in COVID-19 patients [54], hip fracture patients [55,56], patients with infectious diseases [57], newborn patients [58], the lactate-to-albumin ratio in patients with acute myocardial infarction [59], the albumin-bilirubin score in patients with hypertrophic cardiomyopathy [60], a combined index of hemoglobin, albumin, lymphocyte, and platelet in patients with acute exacerbations of chronic obstructive pulmonary disease [61], and the albumin-to-prealbumin ratio in hemodialysis patients [62]. In malnourished patients, atrophy of the diaphragmatic muscle and loss of muscle mass can occur, in addition to a deterioration of the immune response, which leads to an increased risk of pneumonia.…”

Preoperative ALBI grade predicts mortality in patients undergoing curative surgery for pancreatic head cancer

“…[36] The anti-inflammatory and antioxidant effects of bilirubin and albumin may play a role and may reflect the inflammatory and immune system impairment caused by the tumor. [16] The liver is essential for regulating innate and acquired immunity against cancer. Albumin not only indicates the nutritional condition of a patient, but also demonstrates its relationship with systemic inflammation.…”

“…[14,37,41] A recent study has shown a correlation between ALBI grade and hypertrophic cardiomyopathy survival. [16] Two components of the ALBI grade; total bilirubin, and albumin, were thought of as related to inflammation and oxidative stress. ALBI grade was reported as survival predictor in vascular pathologies and acute cardiac failure.…”

“…Hepatic dysfunction can indicate a patient's prognosis for several pathologies. [16,37,44] Table 4 Comparison of clinical factors according to ALBI grade.…”

“…[4–8] Then, the ALBI grade was reported as a reliable predictor of survival in a variety of pathologies, including inflammatory, vascular, and tumor-related pathologies. [9–16] Also, a correlation between ALBI grade and survival, tumor relapse, and tumor load in solid tumors has been recognized. [13,17,18] The relationship between the ALBI grade and survival of solid tumors described in a few recent research has led us to conclude that ALBI grade may be useful in the follow-up of cancer patients.…”