Document Detail

Liver function, in-hospital and post-discharge clinical outcome in patients with acute heart failure - Results from Pre-RELAX-AHF.
MedLine Citation:
PMID:  24642379     Owner:  NLM     Status:  Publisher    
BACKGROUND: Elevated plasma concentrations of liver function tests are prevalent in patients with chronic heart failure (HF). Little is known about liver function in patients with acute HF. We aimed to assess the prevalence and prognostic value of serial measurements of liver function tests in patients admitted with acute decompensated HF.
METHODS: We investigated liver function tests from all 234 patients from the Pre-RELAX-AHF study at baseline and during hospitalization. The endpoints were worsening HF through day 5, 60 day mortality or rehospitalization and 180 day mortality.
RESULTS: Mean age was 70±10 years, 56% were male and most patients were in NYHA III/IV (73%). Abnormal liver function tests were frequently found for ALT (12%), AST (21%), alkaline phosphatase (12%) and total bilirubin (19%), while serum albumin (25%) and total protein (9%) were decreased. In-hospital changes were very small. On a continuous scale, baseline ALT and AST were associated with 180 day mortality (HR (per doubling)=1.52, P=0.030 and HR (per doubling)=1.97, P=0.013) and worsening HF through day 5 (HR (per doubling)=1.72, P=0.005 and HR (per doubling)=1.95, P=0.008). Albumin was associated with 180 day mortality (HR=0.86, P=0.001) but not with worsening HF (HR=0.95, P=0.248). Total protein was only associated with worsening HF (HR=0.91, P=0.004).
CONCLUSIONS: Abnormal liver function tests are often present in patients with acute HF and are associated with an increased risk for mortality, rehospitalization and in-hospital worsening HF.
Vincent M van Deursen; Christopher Edwards; Gad Cotter; Beth A Davison; Kevin Damman; John R Teerlink; Marco Metra; G Michael Felker; Piotr Ponikowski; Elaine Unemori; Thomas Severin; Adriaan A Voors
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-3-15
Journal Detail:
Title:  Journal of cardiac failure     Volume:  -     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2014 Mar 
Date Detail:
Created Date:  2014-3-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
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