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

Pubmed ID: 26844764

Pubmed Central ID: PMC4970961

Journal: Journal of cardiac failure

Publication Date: Nov. 1, 2016

Affiliation: Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: tangw@ccf.org.

MeSH Terms: Humans, Male, Female, Aged, United States, Logistic Models, Middle Aged, Survival Analysis, Randomized Controlled Trials as Topic, Risk Assessment, Proportional Hazards Models, Heart Failure, Prospective Studies, Cause of Death, Chi-Square Distribution, Prognosis, Severity of Illness Index, Diuretics, Hospital Mortality, Double-Blind Method, Kidney Function Tests, Renal Insufficiency, Acute Disease, Serum Albumin, Biomarkers

Grants: U10 HL084904, U10 HL110336, U10 HL110309, U10 HL110262, U10 HL110312, U10 HL110337

Authors: Tang WH, Grodin JL, Stevens SR, Lala A, DeVore AD, Cooper LB, AbouEzzeddine OF, Mentz RJ, Groarke JD, Joyce E, Rosenthal JL, Vader JM

Cite As: Grodin JL, Lala A, Stevens SR, DeVore AD, Cooper LB, AbouEzzeddine OF, Mentz RJ, Groarke JD, Joyce E, Rosenthal JL, Vader JM, Tang WH. Clinical Implications of Serum Albumin Levels in Acute Heart Failure: Insights From DOSE-AHF and ROSE-AHF. J Card Fail 2016 Nov;22(11):884-890. Epub 2016 Feb 2.

Studies:

Abstract

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 function (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.