Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Hypoalbuminemia is considered as poor prognostic factor in patients with certain chronic diseases, such as cancer and end-stage renal failure. Low serum albumin is common in patients with heart failure; nevertheless, the relationship between serum albumin and heart failure prognosis has not been well verified.
OBJECTIVE:
To elucidate the effect of serum albumin level on prognosis of patients with systolic heart failure.
METHODS:
This study included 250 patients with systolic heart failure who were admitted to Baghdad teaching hospital between February 2008 and April 2010. Patients were divided into groups based on presence of hypoalbuminemia (≤3.4 g/dL).
RESULTS:
The mean age of patients was 55 ± 14 years and the mean left ventricular ejection fraction [LVEF] was 28 ± 11 %). The mean serum albumin was 3.9 ± 0.7 g/dL; 27.2 % of patients had hypoalbuminemia. Patients with and without low serum albumin levels were similar in age, cause of heart failure, and ejection fraction. Patients with hypoalbuminemia had higher New York Heart Association (NYHA) class, higher serum urea, creatinine and C-reactive protein levels but lower levels of sodium, hemoglobin, and cholesterol. In patients with body mass index (BMI) < 25 kg/m2, 26% had hypoalbuminemia compared to 20% in those with BMI ≥25 kg/m2 (P ≤ 0.01). One-year survival was 64.71% in patients with and 85.72% in those without hypoalbuminemia (P < 0.001). Risk-adjusted hazard ratio for 1-year mortality was 1.9 (1.5-2.4).
CONCLUSION:
Hypoalbuminemia is common in patients with heart failure and is independently associated with increased mortality.