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

• Published in: Journal of cardiac failure 2014-05, Vol.20 (5), p.350-358
• Main Authors: Bonilla-Palomas, Juan Luis, MD, PhD, Gámez-López, Antonio Luis, MD, PhD, Moreno-Conde, Mirian, MD, PhD, López-Ibáñez, María Cristina, MD, PhD, Anguita-Sánchez, Manuel, MD, PhD, Gallego de la Sacristana, Ángel, MD, García-Catalán, Francisco, MD, PhD, Villar-Ráez, Antonia, MD, PhD
• Format: Article
• Language: English
• Subjects: Acute Disease; Aged; Aged, 80 and over; Cardiovascular; congestion; Female; Heart Failure - diagnosis; Heart Failure - mortality; Hospital Mortality - trends; Humans; Hypoalbuminemia - diagnosis; Hypoalbuminemia - mortality; Inflammation; Male; malnutrition; Malnutrition - diagnosis; Malnutrition - mortality; Middle Aged; Prospective Studies; Time Factors
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2014.01.016

Abstract Background The causes of hypoalbuminemia in patients with acute heart failure (HF) remain poorly defined, and the association between hypoalbuminemia and hospital and long-term mortality has been only partially evaluated. This study sought to analyze the causes of hypoalbuminemia in acute HF patients and determine its impact on hospital and long-term mortality. Methods and Results A total of 362 consecutive acute HF patients were assessed. The patients were divided into 2 groups according to the presence or absence of hypoalbuminemia (albumin ≤3.4 g/dL), and the independent association of each variable with hypoalbuminemia and hospital mortality was assessed with the use of multiple logistic regression. The association between hypoalbuminemia and long-term mortality was assessed with the use of Cox multivariate analysis. In total, 108 patients (29.8%) were classified as having hypoalbuminemia. Older age, higher C-reactive protein levels, and lower levels of total protein, prealbumin, transferrin, and lymphocytes were independently associated with hypoalbuminemia. Hospital mortality was 8% and was independently associated with hypoalbuminemia. A total of 333 patients were discharged. Hypoalbuminemia was an independent predictor of mortality. Conclusions Hypoalbuminemia in acute HF patients was associated with higher hospital mortality and served as an independent predictor of long-term mortality. Malnutrition and inflammation were factors causing hypoalbuminemia in this clinical setting.