title: Albumin levels predict survival in patients with heart failure and preserved ejection fraction.
abstract: OBJECTIVE
  Low serum albumin is common in patients with systolic heart failure and is associated with increased mortality. However, the relationship between albumin and outcome in patients with heart failure and preserved ejection fraction (HFPEF) is not known. The aim of this study was to investigate the effect of serum albumin level on survival in patients with HFPEF.
  
  
  RESULTS
  We studied 576 consecutive HFPEF patients (left ventricular ejection fraction ≥50%) admitted to our hospital from 2006 to 2009. Standard demographics, transthoracic echocardiography, and routine blood testing including albumin levels were obtained shortly after admission. Outcome was assessed at 1 year after admission. Hypoalbuminaemia (≤34 g/L) was detected in 160 (28%) at admission; and all patients were then divided into hypoalbuminaemia and non-hypoalbuminaemia groups. In the hypoalbuminaemia group, the prevalence of chronic renal failure history, serum creatinine, and urea nitrogen levels were higher when compared with those without hypoalbuminaemia (all P < 0.05). Kaplan-Meier analysis showed that patients with hypoalbuminaemia had a significantly lower survival rate (53% vs. 84%, log-rank χ(2) = 53.3, P < 0.001) and a higher rate of cardiovascular death (21.8% vs. 8.9%, log-rank χ(2) = 19.7, P < 0.001) when compared with those without hypoalbuminaemia. Cox regression further revealed that hypoalbuminaemia, a history of cerebrovascular disease, and older age were the most powerful independent predictors of all-cause mortality in HFPEF patients at 1 year.
  
  
  CONCLUSIONS
  Hypoalbuminaemia is common in HFPEF patients and is associated with increased risk of death. Renal dysfunction may be the main pathophysiological mechanism underlying hypoalbuminaemia in HFPEF patients.
authors.affiliation: Institute of Vascular Medicine and Division of Cardiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Shatin, N.T., Hong Kong.
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
authors.forename: Chin-Pang
authors.initials: CP
authors.lastname: Chan
authors.forename: Bryan P
authors.initials: BP
authors.lastname: Yan
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhang
authors.forename: Yat-Yin
authors.initials: YY
authors.lastname: Lam
authors.forename: Rui-Jie
authors.initials: RJ
authors.lastname: Li
authors.forename: John E
authors.initials: JE
authors.lastname: Sanderson
authors.forename: Andrew J S
authors.initials: AJ
authors.lastname: Coats
authors.forename: Jing-Ping
authors.initials: JP
authors.lastname: Sun
authors.forename: Gabriel Wai-Kwok
authors.initials: GW
authors.lastname: Yip
authors.forename: Cheuk-Man
authors.initials: CM
authors.lastname: Yu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003643:Death; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality; D006801:Humans; D034141:Hypoalbuminemia / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000209:etiology / Q000378:metabolism; D018570:Risk Assessment; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism*; D013318:Stroke Volume; D015996:Survival Rate
chemical_list: D012709:Serum Albumin