Hypoalbuminemia in Acute Heart Failure Patients: Causes and Its Impact on Hospital and Long-Term Mortality

Bonilla-Palomas, Juan L.; Gámez-López, Antonio L.; Moreno-Conde, Mirian; López-Ibáñez, María; Anguita‐Sánchez, Manuel; Sacristana, Ángel Gallego de la; García-Catalán, Francisco; Villar-Ráez, Antonia

doi:10.1016/j.cardfail.2014.01.016

Cited by 127 publications

(104 citation statements)

References 30 publications

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“…It is well known that hyperalbuminemia is related with poor outcome in ADHF, 29,30) although inflammation and fluid retention reduce serum protein levels in the acute phase of hospitalization ( Figure 4). Our study results demonstrated that CONUT and GNRI, including serum albumin, reflected the patients' nutritional status ( Figure 3); thus, it might be difficult to use CONUT and GNRI to assess nutrition in ADHF.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Transthyretin Combined With Mini Nutritional Assessment on Admission Provides Useful Prognostic Information in Patients With Acute Decompensated Heart Failure

et al. 2015

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SummaryDecreased Transthyretin (TTR) can be observed in heart failure patients with malnutrition evaluated by the Mini Nutritional Assessment (MNA). This study investigated whether a combination of different nutritional assessment methods would be useful for assessing prognosis in patients with acute decompensated heart failure (ADHF).This prospective study included 52 patients with ADHF (mean age, 71.1 ± 14.7 years; men 55.8%) who were admitted to our hospital between June 2012 and August 2013. On admission, nutritional status was evaluated according to levels of TTR and the MNA. Of 52 patients, 28 (53.8%) had TTR < 15 mg/dL, 39 (75.0%) had malnutrition or were at risk of malnutrition (MNA score ≤ 23.5), and 21 (40.4%) were categorized into group L (MNA score ≤ 23.5 and TTR < 15 mg/dL). Readmission due to worsening heart failure occurred in 12 patients (23.1%), and there were 4 (7.7%) allcause deaths. The 1-year event-free survival rates in group L and the remaining patients (group O) were 27.7% and 85.6%, respectively (P = 0.001). Using Cox multivariate analysis, group L also had a poorer prognosis (hazard ratio 4.35, 95% confidence interval 1.26-17.74, P = 0.020).MNA revealed that 75% of patients with ADHF had malnutrition or were at risk of malnutrition. The combination of low MNA and low TTR on admission can predict the prognosis of patients with ADHF. (Int Heart J 2015; 56: 226-233)

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Section: Discussionmentioning

confidence: 99%

Assessment of Transthyretin Combined With Mini Nutritional Assessment on Admission Provides Useful Prognostic Information in Patients With Acute Decompensated Heart Failure

et al. 2015

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“…15) However, hypoalbuminemia in HF patients often does not resolve despite sufficient energy and protein supplementation. 7) In such patients, the albumin levels may not correctly assess the appropriateness of the ongoing nutritional therapy.…”

Section: Discussionmentioning

confidence: 99%

Utility of Nutritional Screening in Predicting Short-Term Prognosis of Heart Failure Patients

et al. 2018

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SummaryControlling nutritional status (CONUT) uses 2 biochemical parameters (serum albumin and cholesterol level), and 1 immune parameter (total lymphocyte count) to assess nutritional status. This study examined if CONUT could predict the short-term prognosis of heart failure (HF) patients.A total of 482 (57.5%) HF patients from the Ibaraki Cardiovascular Assessment Study-HF (n = 838) were enrolled (298 men, 71.7 ± 13.6 years). Blood samples were collected at admission, and nutritional status was assessed using CONUT. CONUT scores were defined as follows: 0-1, normal; 2-4, light; 5-8, moderate; and 9-12, severe degree of undernutrition. Accordingly, 352 (73%) patients had light-to-severe nutritional disturbances. The logarithmically transformed plasma brain natriuretic peptide (log BNP) concentration was significantly higher in the moderate-severe nutritional disturbance group (2.92 ± 0.42) compared to the normal group (2.72 ± 0.45, P < 0.01). CONUT scores were significantly higher in the in-hospital death patients [4 (3-8), n = 14] compared with patients who were discharged following symptom alleviation [3 (1-5), n = 446, P < 0.05]. With the exception of transferred HF patients (n = 22), logistic regression analysis that incorporated the CONUT score and the log BNP, showed that a higher CONUT score (P = 0.019) and higher log BNP (P = 0.009) were predictors of in-hospital death, and the median duration of hospital stay was 20 days.Our results demonstrate the usefulness of CONUT scores as predictors of short-term prognosis in hospitalized HF patients.(Int Heart J Advance Publication)

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“…[25][26][27][28][29] In addition, prolonged hospitalization leads to hyponatremia, hypoalbuminemia, hypokalemia, renal and hepatic insufficiency, anemia, embolic and hemorrhagic sequelae, and increased nosocomial infections-further increasing morbidity and mortality rates in patients with HF. [30][31][32][33][34][35] Together with identifying patients who are expected to have prolonged hospitalizations, we need to develop new strategies for the follow-up and treatment of these patients, which would create both economic and clinical advantages. Although limited in number, there are studies that relate to the predictors of LOS in HF patients.…”

Section: Discussionmentioning

confidence: 99%

Cancer Antigen 125 is Associated with Length of Stay in Patients with Acute Heart Failure

Kaya¹,

Kurt²,

Beton³

et al. 2017

Texas Heart Institute Journal

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Length of stay is the primary driver of heart-failure hospitalization costs. Because cancer antigen 125 has been associated with poor morbidity and mortality rates in heart failure, we investigated the relationship between admission cancer antigen 125 levels and lengths of stay in heart-failure patients. A total of 267 consecutive patients (184 men, 83 women) with acute decompensated heart failure were evaluated prospectively. The median length of stay was 4 days, and the patients were classified into 2 groups: those with lengths of stay ≤4 days and those with lengths of stay >4 days. Patients with longer lengths of stay had a significantly higher cancer antigen 125 level of 114 U/mL (range, 9–298 U/mL) than did those with a shorter length of stay (19 U/mL; range; 3–68) (P <0.001). The optimal cutoff level of cancer antigen 125 in the prediction of length of stay was >48 U/mL, with a specificity of 95.8% and a sensitivity of 96% (area under the curve, 0.979; 95% confidence interval [CI], 0.953–0.992). In the multivariate logistic regression model, cancer antigen 125 >48 U/mL on admission (odds ratio=4.562; 95% CI, 1.826–11.398; P=0.001), sodium level (P<0.001), creatinine level (P=0.009), and atrial fibrillation (P=0.015) were also associated with a longer length of stay after adjustment for variables found to be statistically significant in univariate analysis and correlated with cancer antigen 125 level. In addition, it appears that in a cohort of patients with acute decompensated heart failure, cancer antigen 125 is independently associated with prolonged length of stay.

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Hypoalbuminemia in Acute Heart Failure Patients: Causes and Its Impact on Hospital and Long-Term Mortality

Cited by 127 publications

References 30 publications

Assessment of Transthyretin Combined With Mini Nutritional Assessment on Admission Provides Useful Prognostic Information in Patients With Acute Decompensated Heart Failure

Assessment of Transthyretin Combined With Mini Nutritional Assessment on Admission Provides Useful Prognostic Information in Patients With Acute Decompensated Heart Failure

Utility of Nutritional Screening in Predicting Short-Term Prognosis of Heart Failure Patients

Cancer Antigen 125 is Associated with Length of Stay in Patients with Acute Heart Failure

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