Abstract 12348: Urine Albumin to Creatinine Ratio on Admission Predicts Early Rehospitalization in Patients With Acute Decompensated Heart Failure

Abstract

Introduction: Detecting high-risk patients for early rehospitalization is crucial in heart failure patient care. An association of albuminuria with cardiovascular events is well known. However, its predictive impact on rehospitalization for acute decompensated heart failure (ADHF) remains unknown. Hypothesis: The aim of this study was to clarify the utility of urine albumin to creatinine ratio (UACR) in ADHF patients. Methods: Two hundred and sixty consecutive patients who were admitted due to ADHF between December 2017 and April 2019 were enrolled. Further investigated were 140 patients from whom UACR was measured with spot urine samples on admission. The association between UACR and rehospitalization due to HF during 1 year after discharge was evaluated. Results: The mean age of 140 participants was 77.6 years and 55% were men. Only 18% (n=25) of patients presented with normoalbuminuria (UACR&lt:30mg/g·creatinine), whereas 59% (n=83) and 23% (n=32) showed microalbuminuria (UACR30-300mg/g·creatinine) and macroalbuminuria (UACR&gt:300 mg/g·creatinine), respectively. The level of UACR on admission was correlated with the risk of subsequent rehospitalization due to HF (p=0.017). The Receiver operating characteristic analysis indicated that the best cut-off values for the UACR and B-type natriuretic peptide (BNP) levels to predict ADHF rehospitalization were 50 mg/g·creatinine and 824 pg/ml, respectively. When the patients were divided into four groups using both cut-off values, the individual predictive impacts of UACR and BNP on rehospitalization were comparable. In the patients with both elevated UACR and BNP levels, the rehospitalization rate due to HF was higher than those with elevated BNP levels alone (p=0.041). Conclusions: The UACR is useful, when combined with BNP levels, to predict the risk for HF rehospitalization.