Abstract 14922: Association of Increase of Serum Albumin Levels During Hospitalization With 1-year Outcomes for Acute Heart Failure

Abstract

Introduction: Hypoalbuminemia is a well-known prognostic factor in acute heart failure (AHF). Hypothesis: We hypothesized that there is an favorable association of the increase in serum albumin levels during hospitalization with 1-year clinical outcomes in patients hospitalized for AHF. Methods: Using the data of the consecutive 3717 patients hospitalized for AHF and discharged alive in the Kyoto Congestive Heart Failure registry, we evaluated the baseline and therapeutic factors associated with the increase of serum albumin levels during hospitalization for AHF. Next, we compared the effect of increase of albumin for the primary composite outcome measures compromising all-cause death and HF hospitalization using a Cox proportional hazard model. Results: The patients in the increase of albumin group (N=1083, 34%) were younger and less likely to have a larger body mass index and renal dysfunction than those in the non-increase group (N=2077, 66%). Median follow-up was 470 days with 96% 1-year follow-up rate. The risk for the primary outcome measure in the increase group relative to the non-increase group was significantly low (adjusted hazard ratio [HR]: 0.78, 95% confidence interval [CI]: 0.69-0.90: P=0.0004) after adjusting confounders including baseline albumin levels. When stratified by the quartiles of albumin levels at discharge, the trend was more evident in the lower quartiles of albumin levels but without interaction (interaction P=0.38). Conclusions: The increase of albumin was associated with lower 1-year risk for the composite of all-cause death and HF hospitalization in patients with hospitalized AHF, independently of baseline albumin levels.