Serum Albumin Concentration and Heart Failure Risk: The Health, Aging, and Body Composition Study Público
Mangalat, Deepa (2009)
Published
Abstract
Aims: To evaluate the association between serum albumin
concentration and risk for heart
failure (HF).
Methods and Results: We evaluated 2907 participants without
HF at baseline (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 nested
multivariable Cox models controlling for HF predictors,
inflammatory markers, and incident
coronary events. During a median follow-up of 9.4 years, 342
(11.8%) participants developed HF (incidence, 14.9 per 1000
person-years). Serum albumin was a time-dependent predictorof HF,
with significance retained for up to 4 years (baseline HR per
-1g/L, 1.12; 95% CI,1.05-1.19, P<0.001, annual rate of HR
decline, 2.1%; 95% CI, 0.8-3.4%, P=0.002). This association
persisted in models controlling for HF predictors, inflammatory
markers, and incident coronary events (baseline HR per -1g/L, 1.11;
95% CI, 1.06-1.17, P<0.001 annual rate of HR decline, 0.5%, 95%
CI, 0.1-1.0%, P=0.02), and was consistent in both sexes and in
whites and blacks. Post-HF ejection fraction (EF) was available in
265/342 (77.5%) cases. In fully adjusted models, albumin was
significantly associated with HF risk for the 136 cases with EF
≥40% (HR, 1.13; 95% CI, 1.03-1.25; P=0.009), but not for the
129 cases with EF<40% (HR, 1.10; 95% CI, 0.97-1.25;
P=0.16).
Conclusion: Serum albumin concentration is associated with a
time-dependent risk for HF;
this association may be stronger for HF with preserved EF.
Table of Contents
TABLE OF CONTENTS
INTRODUCTION………………………………………………………………………..1
BACKGROUND.………………………………………………………………………….2
METHODS..……………………………………………………………………………….4
RESULTS…………………………………………………………………………………..9
DISCUSSION...……………………………………………………………………….11
REFERENCES...……………………………………………………………………….15
TABLES..…………………………………………………………………………………18
FIGURES...………………………………………………………………………………24
LIST OF TABLES
Table 1. Baseline Participant
Characteristics……………………………………………......................18
Table 2. Correlation between Heart Failure Risk Factors and
Inflammatory Biomarkers
And Serum
Albumin…………………………………………………...................................................20
Table 3. Baseline Serum Albumin Concentration and Risk for
Incident Heart Failure…….....21
Table 4. Baseline Serum Albumin Concentration by Incident
Heart Failure Status Over
Time…...………………………………………………………………………...............................................22
Table 5. Association of Serum Albumin with Incident Heart
Failure: Subgroup Analyses...23
LIST OF FIGURES
Figure 1. Flowchart for Study Participants Evaluated in
Statistical Analysis…................24
Figure 2. Unadjusted Kaplan Meier Curves: Survival Without
Heart Failure Stratified on
Albumin
Quartile………………………………………………………………............................................25
Figure 3. Fitted Kaplan Meier Curves: Survival Without Heart
Failure Stratified on
Albumin
Quartile……………………………………………………………..............................................26
Figure 4. Log-Log Survival Curves of Albumin Associated with
Incident Heart Failure…....27
Figure 5. Hazard Ratio of Albumin Over Time, Evaluated at 1
Year Intervals…………….......28
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