Serum bilirubin as a prognostic marker in patients with acute decompensated heart failure

Chintanaboina, Jayakrishna; Haner, Matthew; Sethi, Arjinder; Patel, Nimesh; Tanyous, Walid; Lalos, Alexander; Pancholy, Sameer

doi:10.3904/kjim.2013.28.3.300

Cited by 21 publications

(14 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They found that increased total bilirubin is coincident with cardiac decompensation and it also predicts a worse long-term death of CHF, presumably through the potential liability to both decompensated RV function and lower cardiac output syndrome which occurs simultaneously when HF deteriorates. This also comes in agreement with Chintanaboina , et al2013 who concluded that in patients with acute decompensated HF, elevated serum TB on admission with or without low EF (< 35%) predicts a worse prognosis and early future readmission secondary to HF (14). Finally, Allen et al, 2009 found that elevated total bilirubin is one of the strongest predictor for poor prognosis of CHF (15) .…”

Section: Discussionsupporting

confidence: 76%

Changes of Portal Flow in Patients with an Acute Exacerbation of Heart Failure and Liver Congestion

Zaghla¹,

Sabawy²,

Gomma³

et al. 2015

JMSCR

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 76%

Changes of Portal Flow in Patients with an Acute Exacerbation of Heart Failure and Liver Congestion

Zaghla¹,

Sabawy²,

Gomma³

et al. 2015

JMSCR

View full text Add to dashboard Cite

“…This is different to previous studies, which have found some correlation between bilirubin with death [11][12][13].…”

Section: Discussioncontrasting

confidence: 55%

Association of Abnormal Liver Function Tests to Outcomes in Patients with a New Diagnosis of Heart Failure with Reduced Ejection Fraction in the Outpatient Clinic

Koganti¹,

DasGupta²,

Crossman³

et al. 2017

J Cardiovasc Dis Diagn

View full text Add to dashboard Cite

Aim: To evaluate the relationship of abnormal Liver Function Tests (LFTs) to outcomes in patients with heart failure due to reduced ejection fraction (HFREF) at the time of diagnosis in the heart failure clinic. Methods:We undertook a retrospective analysis of all patients diagnosed with HFREF in the heart failure outpatient clinic of a tertiary teaching hospital from 2007 to 2011. Ninety-five patients with abnormal LFTs at presentation were compared with 127 contemporaneous randomly chosen patients with normal LFTs and their outcomes were analyzed. Time to event data mortality and admission rates, as well as length of hospital stay during admissions were assessed. Results:Of 222 patients 69% were Male. The mean age across both the groups was 69.2 ± 13.2 years. The major ethnic group was of white background (78%). Majority of patients were in NYHA class 2 (54.5%). On multivariate analysis, low albumin at the time of diagnosis was the strongest predictor of all cause death (OR 1.24, 95% CI 1.15-1.35, p<0.0001). Patients in the abnormal LFT group had a longer in-hospital stay compared to those in the normal LFT group (25.9 ± 29.1 days vs. 17.2 ± 20.5 days, p=0.01). Low albumin and elevated alkaline phosphatase (ALP) were the strongest predictors of increased length of in-hospital stay following heart failure related admissions on multivariate analysis (OR -0.583, CI -1.119, -0.046, p=0.035 and OR 0.033, CI 0.005, 0.061, p=0.02, respectively). Every unit increase of albumin resulted in reduction of in hospital stay by 0.875 days. Time to event analysis showed more deaths in the abnormal LFT group when compared to the normal LFT group (log rank test p=0.012). Although an elevated ALP was seen to be associated with readmission, multivariate analysis found this to be a trend only, with none of the LFTs being predictive. Conclusion:Abnormal LFTs in the outpatient setting in patients with HFREF was associated with higher mortality in this study. Low Albumin was independently associated with mortality and length of hospital stay due to heart failure. An elevated alkaline phosphatase also seems to be important in predicting length of stay in hospital. Triaging acute heart failure patients due to Left Ventricular Systolic Dysfunction (LVSD) using abnormal LFTs as biomarkers for more intensive treatment and monitoring would seem advisable. However, this is a retrospective analysis of a relatively small number of patients and the conclusions must be seen in that light.

show abstract

“…In contrast, participants in the present study were 65 years or older and had a mean BMI in the obese range; thus, the participants included in the present study may have been a higher risk population than the participants in either the Chow et al or Timmers et al studies. Extreme elevations in bilirubin levels have recently been shown to be a causal risk factor for specific health conditions (e.g., gallstone disease) (Stender et al, 2013), and elevated bilirubin levels predict poor outcomes in hospitalized patients (Chintanaboina et al, 2013 and Patel et al, 2013). It is presently unclear, however, whether a reduction in bilirubin levels in the absence of liver disease is a desirable outcome.…”

Section: Discussionmentioning

confidence: 99%

Safety and metabolic outcomes of resveratrol supplementation in older adults: results of a twelve-week, placebo-controlled pilot study

Anton

Embry²,

Marsiske

et al. 2014

Experimental Gerontology

View full text Add to dashboard Cite

Resveratrol has been found to have potent antioxidant, anti-inflammatory, and anticarcinogenic effects. The safety and efficacy of resveratrol supplementation in older adults are currently unknown. We conducted a double-blind, randomized, placebo-controlled trial to examine the safety and metabolic outcomes in 32 overweight, older adults (mean age, 73 ± 7 years). Participants were randomized into one of three treatment groups: (1) placebo, (2) moderate dose resveratrol (300 mg/day), and (3) high dose resveratrol (1000 mg/day). Both resveratrol and placebo were orally ingested in capsule form twice daily for 90 days. Blood chemistry values remained within the normal range, and there were no significant differences in the number of participants reporting adverse events across conditions. Compared to placebo, glucose levels were significantly lower at post-treatment among participants randomized to both resveratrol conditions, with and without adjustment for the corresponding baseline values (ps < 0.05). Glucose values of participants in the treatment groups, however, were not significantly different from baseline levels. These findings suggest that short-term resveratrol supplementation at doses of 300 mg/day and 1000 mg/day does not adversely affect blood chemistries and is well tolerated in overweight, older individuals. These findings support the study of resveratrol for improving cardio-metabolic health in older adults in larger clinical trials.

show abstract

Serum bilirubin as a prognostic marker in patients with acute decompensated heart failure

Cited by 21 publications

References 10 publications

Changes of Portal Flow in Patients with an Acute Exacerbation of Heart Failure and Liver Congestion

Changes of Portal Flow in Patients with an Acute Exacerbation of Heart Failure and Liver Congestion

Association of Abnormal Liver Function Tests to Outcomes in Patients with a New Diagnosis of Heart Failure with Reduced Ejection Fraction in the Outpatient Clinic

Safety and metabolic outcomes of resveratrol supplementation in older adults: results of a twelve-week, placebo-controlled pilot study

Contact Info

Product

Resources

About