A high albumin-bilirubin score (ABS) independently predicted both short-term (HR 2.01) and long-term (HR 1.36) mortality in patients with heart failure.
Meta-Analysis
Do high values of albumin-based indices predict increased mortality in patients with heart failure?
Albumin-based indices, particularly the albumin-bilirubin score, fibrinogen-albumin ratio, BUN-albumin ratio, and lactate-albumin ratio, are significant independent predictors of short- and long-term mortality in patients with heart failure.
Hazard Ratio: 2.01 (95% CI 1.01–4)
p-value: p=0.05
Albumin-based indices have been used to predict mortality after heart failure (HF). We hereby examined the utility of albumin-globin ratio, lactate-albumin ratio, blood urea nitrogen (BUN)-albumin ratio, fibrinogen-albumin ratio, and albumin-bilirubin score (ABS) in predicting mortality after HF. We searched Embase, PubMed, Web of Science, and Scopus databases up to 2nd October 2024 for studies examining association between albumin-based indices and mortality after HF. A random-effect meta-analysis was conducted using multivariate adjusted data to calculate pooled hazard ratio (HR) with 95% confidence intervals (CI). Subgroup analysis was conducted for short-term (< 90 days) and long-term mortality (≥ 1 year) where possible. There were seven studies on ABS, three studies each on BUN-albumin and fibrinogen-albumin ratio, and two studies each for albumin-globulin and lactate-albumin ratio. Meta-analysis showed that ABS was predictive of both short-term (HR: 2.01 95% CI: 1.01, 4.00 I 2 = 62% p = 0.05) and long-term (HR: 1.36 95% CI: 1.05, 1.76 I 2 = 49% p = 0.02) mortality after HF. Meta-analysis also showed that high fibrinogen-albumin ratio (HR: 1.12 95% CI: 1.09, 1.14 I 2 = 0% p < 0.00001), BUN-albumin ratio (HR: 1.84 95% CI: 1.28, 2.64 I 2 = 64% p = 0.001), and lactate-albumin ratio (HR: 1.84 95% CI: 1.68, 2.01 I 2 = 0% p < 0.00001) were predictors of mortality after HF. Very low quality of evidence indicates that albumin-based indices can predict mortality after HF. ABS was found to independently predict short and long-term mortality after HF. Other ratios like the albumin-globin ratio, lactate-albumin ratio, BUN-albumin ratio, and fibrinogen-albumin ratio were also found to predict mortality after HF albeit with limited data.
Ji et al. (Thu,) conducted a meta-analysis in Heart failure. High albumin-bilirubin score (ABS) vs. Low albumin-bilirubin score was evaluated on Short-term mortality (< 90 days) (HR 2.01, 95% CI 1.01-4.00, p=0.05). A high albumin-bilirubin score (ABS) independently predicted both short-term (HR 2.01) and long-term (HR 1.36) mortality in patients with heart failure.