Association of low serum albumin concentration and adverse cardiovascular events in stable coronary heart disease

Chien, Shih Chieh; Chen, Chun‐Yen; Leu, Hsin Bang; Su, Cheng‐Huang; Yin, Wei Hsian; Tseng, Wei Kung; Wu, Yen Wen; Lin, Tsung-Hsien; Chang, Kuan Cheng; Wang, Ji Hung; Wu, Chin-Pyng; Yeh, Hung I.; Chen, Jaw Wen

doi:10.1016/j.ijcard.2017.04.003

Cited by 81 publications

(51 citation statements)

References 31 publications

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“…CONUT score was determined by assessing the circulating levels of three laboratory markers, SA, TLC, and total cholesterol, and GNRI was calculated by the following formula: GNRI = [1.489 × albumin (g/L)]+[41.7 × (weight/WLo)], where WLo represents ideal weight calculated by the Lorentz formula . Patients were categorized as having either better nutrition or malnutrition status according to the level of each nutritional index using previously reported cut‐offs of 3.5 g/dL for SA level, 38 for PNI, 3 for CONUT score, and 92 for GNRI . Patients were stratified by BMI in accordance with recommendations from the Department of Health in Taiwan as follows: normal weight (BMI < 24 kg/m 2 ), overweight (24 ≤ BMI < 27 kg/m 2 ), and obese (BMI ≥ 27 kg/m 2 ) .…”

Section: Methodsmentioning

confidence: 99%

“…Patients with HFpEF, however, exhibit ‘sarcopenic’ obesity, which is characterized by excessive BMI and low muscle mass with multiple co‐morbidities, excessive visceral adiposity, and heightened systemic inflammation . On the other hand, BMI alone fails to incorporate information that accurately describes a condition of protein‐energy wasting and relevant harmful biological effects, which are known to be highly prognostic in HF . While it has been recently proposed that poor nutritional status in the context of hypoalbuminaemia is associated with a risk of death for patients with HFpEF, the beneficial effects of albumin level over the course of HF syndrome (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Malnutrition in acute heart failure with preserved ejection fraction: clinical correlates and prognostic implications

Chien

Lin

et al. 2019

ESC Heart Failure

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AimsThis study aimed to evaluate the prognostic significance of nutritional status in post‐discharge Asians with heart failure with preserved ejection fraction (HFpEF).Methods and resultsWe examined the prognostic implications of body mass index (BMI) and nutritional markers among consecutive patients hospitalized for HFpEF. Nutritional metrics were estimated by serum albumin (SA), prognostic nutritional index (PNI), Controlling Nutritional Status (CONUT) score, and geriatric nutritional risk index. Among 1120 patients (mean age: 77.2 ± 12.6 years, 39.4% men), mean SA levels, PNI, CONUT scores, and geriatric nutritional risk index were 3.3 ± 0.6 g/dL, 40.2 ± 8.7, 5.5 ± 2.1, and 95.9 ± 14.5, respectively. Lean body size, higher white blood cell counts and C‐reactive protein levels, anaemia, and lack of angiotensin blocker use were independently associated with malnutrition (defined by SA < 3.5 g/dL). Higher SA levels [hazard ratio (HR): 0.67 (95% confidence interval, CI: 0.53–0.85)], higher PNI [HR: 0.97 (95% CI: 0.95–0.99)], and higher geriatric nutritional risk index [HR: 0.98 (95% CI: 0.97–0.99)] (all P < 0.05) were all associated with longer survival, with higher CONUT score [HR: 1.08 (95% CI: 1.02–1.13)] exhibited higher mortality in Cox regression models and with higher SA levels/PNI but not BMI further contributing to the reduced rate of re‐hospitalization (both P < 0.05). Categorizing BMI (25 kg/m2 as cut‐off) and nutritional status showed significantly higher mortality rates among patients with lower BMI/malnutrition than among those with BMI/better nutrition (SA level, PNI, and CONUT score, all P < 0.01). Restricted cubic spline regression revealed a marked survival benefit of better nutrition with increasing BMI (adjusted P interaction for both SA level and PNI: <0.001; adjusted P interaction for CONUT score: 0.046).ConclusionsMalnutrition was frequently and strongly associated with systemic inflammation in Asian patients hospitalized for acute HFpEF. Our findings also indicate that nutrition may play a pivotal role in metabolic protection in this population.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Malnutrition in acute heart failure with preserved ejection fraction: clinical correlates and prognostic implications

Chien

Lin

et al. 2019

ESC Heart Failure

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“…Previous epidemiological studies have shown an inverse association between serum albumin level and coronary heart disease, 42 stroke 43 and all cause mortality. 14…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14][15] Hypoalbuminaemia may be a marker of comorbidity burden. [12][13][14][15] Hypoalbuminaemia may be a marker of comorbidity burden.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have demonstrated an association between a low serum albumin level and increased incidence of cardiovascular disease, cardiovascular morbidity and mortality. [12][13][14][15] Hypoalbuminaemia may be a marker of comorbidity burden. 16 Furthermore, a low serum albumin level may be a reflection of inflammatory burden predisposing to heart failure 17,18 and can predict protein-energy malnutrition, cardiovascular disease and outcomes in patients with CKD.…”

Section: Introductionmentioning

confidence: 99%

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Serum albumin level and abnormal corrected QT interval in patients with coronary artery disease and chronic kidney disease

et al. 2018

Internal Medicine Journal

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Impact of readmissions on octogenarians with heart failure with preserved ejection fraction: PURSUIT‐HFpEF registry

et al. 2021

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Aims Heart failure (HF) readmissions with preserved ejection fraction (HFpEF) are increasing in the elderly, which is a major socioeconomic problem. We investigated the clinical impact of HF readmissions (HFR) on octogenarians with HFpEF. Methods and resultsWe enrolled consecutive octogenarians (≥80 years old) from June 2016 to February 2020 in PURSUIT-HFpEF registry. We divided them into HFR group readmitted for HF during the follow-up period and non-HF readmission (non-HFR) group. We evaluated the impact of HFR on all-cause mortality, cardiac death, and quality of life (QOL). Additionally, we evaluated the factors at discharge correlated with HFR. HFR group comprised 116 patients (21.4%). Among all-cause deaths, 40 patients suffered cardiac deaths (48.2%). The Kaplan-Meier analysis revealed a similar prognosis between HFR and non-HFR groups as well as similar incidences of HF deaths. The QOL scores had significantly deteriorated by 1 year later in the HFR group (0.71 ± 0.19 vs. 0.59 ± 0.21, P < 0.001), while it was similar at 1 year in the non-HFR group. In the multivariate analysis, diabetes mellitus (DM) (P = 0.019), N-terminal pro-B-type natriuretic peptide (NT-pro BNP) levels ≥ 1611 pg/mL (P < 0.001), and serum albumin level ≤ 3.7 g/dL (P = 0.011) were useful markers for HFR in octogenarians. Conclusions In octogenarians with HFpEF, HF readmission was not directly correlated with the prognosis but was well correlated with the QOL. Close follow-up is essential to decrease HFR of octogenarians with HFpEF with DM, high NT-pro BNP (≥1611 pg/mL) and low albumin (≤3.7 g/dL) levels at discharge.

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Association of low serum albumin concentration and adverse cardiovascular events in stable coronary heart disease

Cited by 81 publications

References 31 publications

Malnutrition in acute heart failure with preserved ejection fraction: clinical correlates and prognostic implications

Malnutrition in acute heart failure with preserved ejection fraction: clinical correlates and prognostic implications

Serum albumin level and abnormal corrected QT interval in patients with coronary artery disease and chronic kidney disease

Impact of readmissions on octogenarians with heart failure with preserved ejection fraction: PURSUIT‐HFpEF registry

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