Clinical and Prognostic Values of ALBI Score in Patients With Acute Heart Failure - 23/09/20

Doi : 10.1016/j.hlc.2019.12.003

Yuya Matsue, MD, PhD ^a,^b, Nobuyuki Kagiyama, MD, PhD ^c,^d,^⁎ , Tetsuo Yamaguchi, MD, PhD ^e, Shunsuke Kuroda, MD ^f, Takahiro Okumura, MD, PhD ^g, Keisuke Kida, MD, PhD ^h, Atsushi Mizuno, MD ⁱ, Shogo Oishi, MD ^j, Yasutaka Inuzuka, MD, PhD ^k, Eiichi Akiyama, MD ^l, Ryuichi Matsukawa, MD, PhD ^m, Kota Kato, MD, PhD ⁿ, Satoshi Suzuki, MD, PhD ^o, Takashi Naruke, MD, PhD ^p, Kenji Yoshioka, MD ^f, Tatsuya Miyoshi, MD, PhD ^q, Yuichi Baba, MD ^r, Masayoshi Yamamoto, MD, PhD ^s, Kazuo Mizutani, MD, PhD ^t, Kazuki Yoshida, MD, MPH, MS ^u, Takeshi Kitai, MD, PhD ^v,^w
^a Department of Cardiology, Juntendo University and Cardiovascular, Tokyo, Japan
^b Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
^c Department of Cardiology, The Sakakibara Heart Institute of Okayama, Okayama, Japan
^d Heart and Vascular Institute, West Virginia University, WV, USA
^e Department of Cardiology, Japanese Red Cross Musashino Hospital, Tokyo, Japan
^f Department of Cardiology, Kameda Medical Center, Chiba, Japan
^g Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
^h Department of Cardiology, St. Marianna University School of Medicine, Kawasaki, Japan
ⁱ Department of Cardiology, St. Luke's International Hospital, Tokyo, Japan
^j Department of Cardiology, Himeji Cardiovascular Center, Himeji, Japan
^k Department of Cardiology, Shiga Medical Center for Adults, Moriyama, Japan
^l Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
^m Division of Cardiology, Cardiovascular and Aortic Center, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
ⁿ Department of Cardiology, Tokyo Medical University, Tokyo, Japan
^o Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
^p Department of Cardiovascular Medicine, Kitasato University School of Medicine, Tokyo, Japan
^q Department of Cardiology, Ako City Hospital, Ako, Japan
^r Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Kochi, Japan
^s Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
^t Department of Cardiology, Kobe Century Memorial Hospital, Kobe, Japan
^u Departments of Epidemiology & Biostatistics, Harvard T.H. Chan School of Public Health, Boston, USA
^v Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
^w Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA

^∗Corresponding author at: West Virginia University Heart and Vascular Institute Innovation Center, 1 Medical Center Drive, Morgantown, WV, USA. Tel.: (304) 598-4000, Fax: (304) 598-6556West Virginia University Heart and Vascular Institute Innovation Center1 Medical Center DriveMorgantownWVUSA

Abstract

Background

Although liver dysfunction is one of the common complications in patients with acute heart failure (AHF), no integrated marker has been defined. The albumin-bilirubin (ALBI) score has recently been proposed as a novel, clinically-applicable scoring system for liver dysfunction. We investigated the utility of the ALBI score in patients with AHF compared to that for a preexisting liver dysfunction score, the Model of End-Stage Liver Disease Excluding prothrombin time (MELD XI) score.

Methods

We evaluated ALBI and MELD XI scores in 1,190 AHF patients enrolled in the prospective, multicentre Registry Focused on Very Early Presentation and Treatment in Emergency Department of Acute Heart Failure study. The associations between the two scores and the clinical profile and prognostic predictive ability for 1-year mortality were evaluated.

Results

The mean MELD XI and ALBI scores were 13.4±4.8 and -2.25±0.48, respectively. A higher ALBI score, but not higher MELD XI score, was associated with findings of fluid overload. After adjusting for pre-existing prognostic factors, the ALBI score (HR 2.11, 95% CI: 1.60–2.79, p<0.001), but not the MELD XI score (HR 1.02, 95% CI: 0.99–1.06, p=0.242), was associated with 1-year mortality. Likewise, area under the receiver-operator-characteristic curves for 1-year mortality significantly increased when the ALBI score (0.71 vs. 0.74, p=0.020), but not the MELD XI score (0.71 vs. 0.72, p=0.448), was added to the pre-existing risk factors.

Conclusions

The ALBI score is potentially a suitable liver dysfunction marker that incorporates information on fluid overload and prognosis in patients with AHF. These results provide new insights into heart-liver interactions in AHF patients.

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Keywords : Heart failure, Liver function, Risk score, Prognosis

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Vol 29 - N° 9

P. 1328-1337 - septembre 2020 Retour au numéro

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Clinical and Prognostic Values of ALBI Score in Patients With Acute Heart Failure - 23/09/20

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