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. 2024 Aug;19(5):1323-1333.
doi: 10.1007/s11739-024-03612-9. Epub 2024 May 22.

Prognostic role of serum albumin levels in patients with chronic heart failure

Giuseppe Armentaro  1 , Valentino Condoleo  1 , Carlo Alberto Pastura  1 , Maria Grasso  2 , Angelo Frasca  1 , Domenico Martire  1 , Velia Cassano  1 , Raffaele Maio  1 , Leonilde Bonfrate  3 , Daniele Pastori  4 , Tiziana Montalcini  5   6 , Francesco Andreozzi  1   6 , Giorgio Sesti  7 , Francesco Violi  4 , Angela Sciacqua  8   9
Affiliations

Prognostic role of serum albumin levels in patients with chronic heart failure

Giuseppe Armentaro et al. Intern Emerg Med. 2024 Aug.

Abstract

Background: Hypoalbuminemia is common in heart failure (HF) patients; however, there are no data regarding the possible long-term prognostic role of serum albumin (SA) in the younger population with chronic HF without malnutrition. The aim of this study was to examine the long-term prognostic role of SA levels in predicting major adverse cardiac events (MACE) in middle-aged outpatients with chronic HF.

Methods: In the present retrospective analysis, 378 subjects with HF were enrolled. MACE (non-fatal ischemic stroke, non-fatal myocardial infarction, cardiac revascularization or coronary bypass surgery, and cardiovascular death), total mortality, and HF hospitalizations (hHF) occurrence were evaluated during a median follow-up of 6.1 years.

Results: In all population, 152 patients had a SA value < 3.5 g/dL and 226 had a SA value ≥ 3.5 g/dL. In patients with SA ≥ 3.5 g/dL, the observed MACE were 2.1 events/100 patient-year; while in the group with a worse SA levels, there were 7.0 events/100 patient-year (p < 0.001). The multivariate analysis model confirmed that low levels of SA increase the risk of MACE by a factor of 3.1. In addition, the presence of ischemic heart disease, serum uric acid levels > 6.0 mg/dL, chronic kidney disease, and a 10-year age rise, increased the risk of MACE in study participants. Finally, patients with SA < 3.5 g/dl had a higher incidence of hHF (p < 0.001) and total mortality (p < 0.001) than patients with SA ≥ 3.5 g/dl.

Conclusions: Patients with chronic HF that exhibits low SA levels show a higher risk of MACE, hHF and total mortality.

Keywords: Albumin; Chronic heart failure; Comorbidities; MACE.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Adjusted Kaplan–Meier on MACE, according to cut-off value of SA, Adjusted for: SA as dichotomous value, IHD, UA as dichotomous value, CKD, and Age as 10 years. MACE major adverse cardiovascular events, SA Serum albumin, IHD ischemic heart disease, UA uric acid, CKD chronic kidney disease
Fig. 2
Fig. 2
A ROC curves on MACE, according to SA as continuous variable. AUC area under the curve, MACE major cardiovascular adverse events, ROC receiver operating characteristic, SA serum albumin. B ROC curves on MACE, according to SA as dichotomous variable. AUC area under the curve, MACE major cardiovascular adverse events, ROC receiver operating characteristic, SA serum albumin
See this image and copyright information in PMC

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