Impact of prealbumin on mortality and hospital readmission in patients with acute heart failure

• Published in: European journal of internal medicine Vol. 43; pp. 36 - 41
• Main Authors: Franco, Jonathan, Formiga, Francesc, Trullas, Joan-Carles, Salamanca Bautista, P, Conde, Alicia, Manzano, Luis, Quirós, Raúl, Franco, Álvaro González, Ezquerro, Alejandro Martín, Montero-Pérez-Barquero, Manuel
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.09.2017
• Subjects: Acute Disease; Acute heart failure; Aged; Aged, 80 and over; Comorbidity; Female; Heart failure; Heart Failure - mortality; Hospital readmission; Humans; Internal Medicine; Kaplan-Meier Estimate; Logistic Models; Male; Mortality; Multivariate Analysis; Natriuretic Peptide, Brain - blood; Patient Readmission - statistics & numerical data; Peptide Fragments - blood; Prealbumin; Prealbumin - analysis; Prognosis; Prospective Studies; Registries; Spain - epidemiology; CRP; NYHA; heart failure; MNA; C-reactive protein; Mortality; Hospital readmission; LVEF; N-terminal prohormone of brain natriuretic peptide; mini nutritional assessment; left ventricular ejection fraction; New York Heart Association; NT-proBNP; Prealbumin; acute heart failure; HF; AHF; Heart failure; Acute heart failure
• ISSN: 0953-6205; 1879-0828
• DOI: 10.1016/j.ejim.2017.05.009

Abstract Background Prealbumin is a maker of nutritional status and inflammation of potential prognostic value in acute heart failure (HF). The aim of this study is to evaluate if low prealbumin levels on admission predict mortality and readmissions in patients with acute HF. Method We conducted a prospective observational cohort study including 442 patients hospitalized for acute HF. Patients were classified in two groups according to prealbumin levels: “normal” prealbumin (> 15 mg) and “low” prealbumin (≤ 15 mg/dL). End-points were mortality and readmissions (all-cause and HF-related) and the combined end-point of mortality/readmission at 180 days. Results Out of 442 patients, 159 (36%) had low and 283 (64%) had normal prealbumin levels Mean age was 79.6 (73.9–84.2, p = 0,405) years and 183 (41%, p = 0,482) were males. After a median 180 days of follow-up, 108 (24%, p = 0,021) patients died and 170 (38%, p = 0,067) were readmitted. Mortality was higher in the low prealbumin group. The combined end-point was more frequent in the low prealbumin group (57% vs. 50%, p = 0.199). In the multivariate analysis the following variables were associated with mortality or readmission: older age, exacerbated chronic HF, higher comorbidity, low systolic blood pressure and hemoglobin values and higher pro brain natriuretic peptide levels. Conclusions Low prealbumin is common (36%) in patients with acute heart failure and it is associated with a higher short-term mortality.