Clinical Implications of Serum Albumin Levels in Acute Heart Failure: Insights From DOSE-AHF and ROSE-AHF

作者：Grodin Justin L; Lala Anuradha; Stevens Susanna R; DeVore Adam D; Cooper Lauren B; AbouEzzeddine Omar F; Mentz Robert J; Groarke John D; Joyce Emer; Rosenthal Julie L; Vader Justin M; Tang W H Wilson^*

来源：Journal of Cardiac Failure, 2016, 22(11): 884-890.

DOI：10.1016/j.cardfail.2016.01.015

• Heart failure
• proteins
• diuretics

Background: Hypoalbuminemia is common in patients with chronic heart failure and, as a marker of disease severity, is associated with an adverse prognosis. Whether hypoalbuminemia contributes to (or is associated with) worse outcomes in acute heart failure (AHF) is unclear. We sought to determine the implications of low serum albumin in patients receiving decongestive therapies for AHF.
Methods and Results: Baseline serum albumin levels were measured in 456 AHF subjects randomized in the DOSE-AHF and ROSE-AHF trials. We assessed the relationship between admission albumin levels (both as a continuous variable and stratified by median albumin [>= 3.5 g/dL]) and worsening renal WRF), worsening heart failure (WHF), and clinical decongestion by 72 hours; 7-day cardiorenal biomarkers; and post-discharge outcomes. The mean baseline albumin level was 3.5 +/- 0.5 g/dL. Albumin was not associated with WRF, WHF, or clinical decongestion by 72 hours. Furthermore, there was no association between continuous albumin levels and symptom change according to visual analog scale or weight change by 72 hours. Albumin was not associated with 60-day mortality, rehospitalization, or unscheduled emergency room visits.
Conclusions: Baseline serum albumin levels were not associated with short-term clinical outcomes for AHF patients undergoing decongestive therapies. These data suggest that serum albumin may not be a helpful tool to guide decongestion strategies.

• 出版日期2016-11