Association between glycated albumin and adverse outcomes in patients with heart failure

ABSTRACT Aims/Introduction Diabetes mellitus is a traditional risk factor for heart failure (HF), and glycated albumin (GA) is a marker to assess short‐term glycemic control. Whether GA has prognostic significance in patients with HF remains unclear. Materials and Methods A total of 717 patients with HF were enrolled in the prospective cohort study. Patients were grouped by the normal upper limit of GA (17%). Kaplan–Meier analysis and Cox proportional hazards regression were used to evaluate the association between GA and prognosis. Results During a mean follow‐up of 387 days, 232 composite endpoint events of hospitalization for HF or all‐cause death occurred. Kaplan–Meier analysis showed a higher rate of adverse events in the higher GA group (GA >17%; log‐rank test P 17%: HR 1.36, 95% CI 1.03–1.80, P = 0.032). Restricted cubic splines showed a linear association between GA and adverse events ( P for non‐linearity = 0.231). There was no significant difference in adverse outcome risk between those with diabetes and GA ≤17% and those without diabetes, whereas the prognosis was worse in those with diabetes and GA >17% (HR 1.56, 95% CI 1.16–2.11, P = 0.004). Compared to the group with normal levels of GA and glycated hemoglobin, the group with GA >17% and glycated hemoglobin >6.5% had a higher risk of adverse events (HR 1.49, 95% CI 1.06–2.10, P = 0.022). Conclusions GA was an independent predictor of HF prognosis. Combining GA and glycated hemoglobin might improve the predictive power of adverse outcomes in patients with HF.