Low albumin (HR 2.13) and markedly elevated AST (HR 2.53) and ALT (HR 2.40) were associated with significantly increased 180-day all-cause mortality in patients with acute heart failure.
Observational (n=189)
No
Are abnormal liver function tests associated with increased mortality in patients with acute heart failure?
Abnormal liver function tests are common in acute heart failure, and specific abnormalities such as low albumin and markedly elevated transaminases are associated with increased 180-day mortality.
Effect estimate: HR 2.13 (95% CI 1.13-4.0)
Absolute Event Rate: 29% vs 15%
p-value: p=<0.05
INTRODUCTION: Acute heart failure (AHF) is associated with multiorgan dysfunction, which may unfavorably affect prognosis. OBJECTIVES: We investigated the prevalence, clinical determinants, and prognostic consequences of abnormal liver function tests (LFTs) in population with AHF. PATIENTS AND METHODS: We conducted a retrospective analysis of patients with AHF, in whom the following LFTs were performed on admission: serum bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), and albumin. Abnormal LFTs were defined as the elevation above the upper normal limit of bilirubin, AST, and ALT, or reduction below the lower normal limit of albumin. RESULTS: The study involved 189 patients (age, 68 ±11 years; men, 68%; de novo AHF, 25%). On admission, abnormal LFTs were observed in 46% of the patients for AST, 31% for ALT, 33% for bilirubin, and 44% for albumin. Only 29% of the patients had all LFTs within the normal ranges. The following variables were independently related to abnormal LFTs: high hemoglobin and N‑terminal pro‑B‑type natriuretic peptide (NT‑proBNP) levels for AST; high hemoglobin, bilirubin, and NT‑proBNP levels for ALT; high hemoglobin, low sodium levels, and dilated right ventricle for bilirubin; and high NT‑proBNP levels for albumin (all P 3 times above the upper normal limit) were associated with increased mortality during 180‑day follow‑up. CONCLUSIONS: Abnormal LFTs are common in patients with AHF and may have prognostic relevance. Among them, only elevated bilirubin was correlated with impaired hemodynamic parameters.
Biegus et al. (Thu,) conducted a observational in Acute heart failure (n=189). Abnormal liver function tests (low albumin) vs. Normal liver function tests was evaluated on All-cause death at 180 days (HR 2.13, 95% CI 1.13-4.0, p=<0.05). Low albumin (HR 2.13) and markedly elevated AST (HR 2.53) and ALT (HR 2.40) were associated with significantly increased 180-day all-cause mortality in patients with acute heart failure.