Serum albumin concentration and heart failure risk The Health, Aging, and Body Composition Study.
BACKGROUND
How serum albumin levels are associated with risk for heart failure (HF) in the elderly is unclear.


METHODS
We evaluated 2,907 participants without HF (age 73.6 +/- 2.9 years, 48.0% male, 58.7% white) from the community-based Health ABC Study. The association between baseline albumin and incident HF was assessed with standard and competing risks proportional hazards models controlling for HF predictors, inflammatory markers, and incident coronary events.


RESULTS
During a median follow-up of 9.4 years, 342 (11.8%) participants developed HF. Albumin was a time-dependent predictor of HF, with significance retained for up to 6 years (baseline hazard ratio [HR] per -1 g/L 1.14, 95% CI 1.06-1.22, P < .001; annual rate of HR decline 2.1%, 95% CI 0.8%-3.3%, P = .001). This association persisted in models controlling for HF predictors, inflammatory markers, and incident coronary events (baseline HR per -1 g/L 1.13, 95% CI 1.05-1.22, P = .001; annual rate of HR decline 1.8%, 95% CI 0.5%-3.0%, P = .008) and when mortality was accounted for in adjusted competing risks models (baseline HR per -1 g/L 1.13, 95% CI 1.05-1.21, P = .001; annual rate of HR decline 1.9%, 95% CI 0.7%-3.1%, P = .002). The association of albumin with HF risk was similar in men (HR per -1 g/L 1.13, 95% CI 1.05-1.23, P = .002) and women (HR per -1 g/L 1.12, 95% CI 1.04-1.22, P = .005) and in whites and blacks (HR per -1 g/L 1.13, 95% CI 1.04-1.22, P< .01 for both races) in adjusted models.


CONCLUSIONS
Low serum albumin levels are associated with increased risk for HF in the elderly in a time-dependent manner independent of inflammation and incident coronary events.
Gopal
Deepa M
DM
Boston University, Boston, MA, USA.
Kalogeropoulos
Andreas P
AP
Georgiopoulou
Vasiliki V
VV
Tang
Wilson W H
WW
Methvin
Amanda
A
Smith
Andrew L
AL
Bauer
Douglas C
DC
Newman
Anne B
AB
Kim
Lauren
L
Harris
Tamara B
TB
Kritchevsky
Stephen B
SB
Butler
Javed
J
D000368:Aged; D001823:Body Composition; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012709:Serum Albumin / Q000032:analysis*; D013318:Stroke Volume
D012709:Serum Albumin