Hypoalbuminemia in acute heart failure patients: causes and its impact on hospital and long-term mortality.
The causes of hypoalbuminemia in patients with acute heart failure (HF) remain poorly defined, and the association between hypoalbuminemia and hospital and long-term mortality has been only partially evaluated. This study sought to analyze the causes of hypoalbuminemia in acute HF patients and determine its impact on hospital and long-term mortality.



A total of 362 consecutive acute HF patients were assessed. The patients were divided into 2 groups according to the presence or absence of hypoalbuminemia (albumin ≤3.4 g/dL), and the independent association of each variable with hypoalbuminemia and hospital mortality was assessed with the use of multiple logistic regression. The association between hypoalbuminemia and long-term mortality was assessed with the use of Cox multivariate analysis. In total, 108 patients (29.8%) were classified as having hypoalbuminemia. Older age, higher C-reactive protein levels, and lower levels of total protein, prealbumin, transferrin, and lymphocytes were independently associated with hypoalbuminemia. Hospital mortality was 8% and was independently associated with hypoalbuminemia. A total of 333 patients were discharged. Hypoalbuminemia was an independent predictor of mortality.



Hypoalbuminemia in acute HF patients was associated with higher hospital mortality and served as an independent predictor of long-term mortality. Malnutrition and inflammation were factors causing hypoalbuminemia in this clinical setting.
Department of Cardiology, Hospital San Juan de la Cruz, Úbeda, Spain. Electronic address: jnlsbnll@hotmail.com.
Juan Luis
JL
Bonilla-Palomas
Department of Cardiology, Hospital San Juan de la Cruz, Úbeda, Spain.
Antonio Luis
AL
Gámez-López
Department of Internal Medicine, Hospital San Juan de la Cruz, Úbeda, Spain.
Mirian
M
Moreno-Conde
Department of Internal Medicine, Hospital San Juan de la Cruz, Úbeda, Spain.
María Cristina
MC
López-Ibáñez
Department of Cardiology, Hospital Universitario Reina Sofía, Córdoba, Spain.
Manuel
M
Anguita-Sánchez
Department of Internal Medicine, Hospital San Juan de la Cruz, Úbeda, Spain.
Angel
A
Gallego de la Sacristana
Department of Gastroenterology and Hepatology, Hospital San Juan de la Cruz, Úbeda, Spain.
Francisco
F
García-Catalán
Department of Internal Medicine, Hospital San Juan de la Cruz, Úbeda, Spain.
Antonia
A
Villar-Ráez
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality*; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D034141:Hypoalbuminemia / Q000175:diagnosis* / Q000401:mortality*; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000401:mortality; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors
Inflammation; congestion; malnutrition