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.