Impact of prealbumin on mortality and hospital readmission in patients with acute heart failure

Abstract

Background: Prealbumin is a maker of nutritional status and inflammation of potential prognostic value in acute heart failure (HF). The aim of this study is to evaluate if low prealbumin levels on admission predict mortality and readmissions in patients with acute HF.

Method: We conducted a prospective observational cohort study including 442 patients hospitalized for acute HF. Patients were classified in two groups according to prealbumin levels: "normal" prealbumin (>15mg) and "low" prealbumin (≤15mg/dL). End-points were mortality and readmissions (all-cause and HF-related) and the combined end-point of mortality/readmission at 180days.

Results: Out of 442 patients, 159 (36%) had low and 283 (64%) had normal prealbumin levels Mean age was 79.6 (73.9-84.2, p=0,405) years and 183 (41%, p=0,482) were males. After a median 180days of follow-up, 108 (24%, p=0,021) patients died and 170 (38%, p=0,067) were readmitted. Mortality was higher in the low prealbumin group. The combined end-point was more frequent in the low prealbumin group (57% vs. 50%, p=0.199). In the multivariate analysis the following variables were associated with mortality or readmission: older age, exacerbated chronic HF, higher comorbidity, low systolic blood pressure and hemoglobin values and higher pro brain natriuretic peptide levels.

Conclusions: Low prealbumin is common (36%) in patients with acute heart failure and it is associated with a higher short-term mortality.