Abstract
Overview: A decrease in serum albumin levels is still often considered a biomarker to predict risk in many acute and chronic clinical settings. However, the impact of decreased serum albumin on patients with heart failure with reduced ejection fraction is not clear.
Methods and results: The study recruited 119 patients with heart failure with reduced ejection fraction who were admitted to the hospital. No patients in the study were diagnosed with nephrotic syndrome, alcoholic cirrhosis, or liver cancer. The in-hospital mortality rate in the study was 10.9%. There was no statistically significant difference (p > 0.05) in age, gender, BMI, heart rate, or cause of decompensation due to acute coronary syndrome. Patients who died had lower systolic and diastolic blood pressure (mmHg) (103.92 ± 28.56 vs. 124.46 ± 23.09; 63.38 ± 17.90 vs. 76.61 ± 15.45), lower ejection fraction (%) (26.38 ± 10.42 vs. 32.49 ± 8.90), lower serum albumin (g/l) (30.24 ± 4.46 vs. 36.96 ± 4.79), and a higher rate of infection (53.8% vs. 19.8%). The differences were statistically significant with p < 0.05. Multivariate regression analysis showed that serum albumin had an independent predictive value for in-hospital mortality. Using the ROC curve, a decrease in serum albumin (< 32.57g/l) predicted the best sensitivity (76.9%) and specificity (79.2%) with p < 0.001 compared to the Get With The Guidline (GWTG) score (>48.5 points) with sensitivity (92.3%) and specificity (67%) for predicting in-hospital mortality with p < 0.001.
Conclusion: Serum albumin levels at admission can be used as a prognostic factor for in-hospital mortality in patients with heart failure with reduced ejection fraction. A decrease in serum albumin < 32.5g/l is associated with an increased rate of in-hospital mortality in these patients.