PT  - JOURNAL ARTICLE
AU  - Lourenço, Patrícia
AU  - Silva, Sérgio
AU  - Friões, Fernando
AU  - Alvelos, Margarida
AU  - Amorim, Marta
AU  - Couto, Marta
AU  - Torres-Ramalho, Paulo
AU  - Guimarães, João Tiago
AU  - Araújo, José Paulo
AU  - Bettencourt, Paulo
TI  - Low prealbumin is strongly associated with adverse outcome in heart failure
AID  - 10.1136/heartjnl-2014-305747
DP  - 2014 Nov 15
TA  - Heart
PG  - 1780--1785
VI  - 100
IP  - 22
4099  - http://heart.bmj.com/content/100/22/1780.short
4100  - http://heart.bmj.com/content/100/22/1780.full
SO  - Heart2014 Nov 15; 100
AB  - Objective Prealbumin is one of the best indicators of nutritional status. We previously showed that prealbumin predicted in-hospital mortality in heart failure (HF) patients. We evaluated if a low discharge prealbumin after admission with acute HF would predict morbidity and mortality. Methods We conducted a prospective observational study. Patients admitted with a primary diagnosis of HF were studied. Follow-up was up to 6 months. Endpoints analysed were: all-cause and HF-death; all-cause and worsening HF hospitalisation. Patients with discharge prealbumin ≤15.0 mg/dL and those with prealbumin >15 mg/dL were compared. A Cox-regression analysis was used to evaluate the prognostic impact of low prealbumin. Results We studied 514 patients. Mean age was 78 years and 45.7% were male. During follow-up, 101 patients died (78 for HF) and 209 patients were hospital readmitted (140 for worsening HF). Median prealbumin was 20.1 (15.3–25.3) mg/dL. Patients with lower prealbumin were more often women, older aged and with non-ischaemic HF; they had lower albumin, haemoglobin and total cholesterol; and higher glomerular filtration rate, C-reactive protein, B-type natriuretic peptide and length of hospital stay. Lower prealbumin associated with less β-blocker and statin use. Patients with discharge prealbumin ≤15 mg/dL had a multivariate adjusted HR of 6-month all-cause and HF death of 1.67 (1.00 to 2.80) and 2.12 (1.19 to 3.79) respectively and of all-cause and HF readmission of 1.47 (1.01 to 2.14) and 1.58 (1.01 to 2.47). Conclusions Patients with discharge prealbumin ≤15 mg/dL have an higher risk of 6 months morbidity and mortality. The unbalance between protein–energy demands and its availability predicts ominous HF outcome.