Abnormal Liver Function Tests in Acute Heart Failure: Relationship with Clinical Characteristics and Outcome in the PROTECT Study

DOI PDF Web Site 被引用文献6件
  • Jan Biegus
    Department of Heart Diseases, Medical University , Wroclaw ,
  • Hans L. Hillege
    Department of Cardiology, University of Groningen, University Medical Centre Groningen , Groningen ,
  • Douwe Postmus
    Department of Cardiology, University of Groningen, University Medical Centre Groningen , Groningen ,
  • Mattia. A.E. Valente
    Department of Cardiology, University of Groningen, University Medical Centre Groningen , Groningen ,
  • Daniel M. Bloomfield
    Merck Research Laboratories , Rahway, NJ ,
  • John G.F. Cleland
    National Heart and Lung Institute, Imperial College London (Royal Brompton and Harefield Hospitals) Department of Cardiology, Castle Hill Hospital, University of Hull
  • Gad Cotter
    Momentum Research Inc. , Durham, NC ,
  • Beth A. Davison
    Momentum Research Inc. , Durham, NC ,
  • Howard C. Dittrich
    University of Iowa Carver College of Medicine Cardiovascular Research Center , Iowa City, IA ,
  • Mona Fiuzat
    Duke Clinical Research Institute, Division of Cardiovascular Medicine, Duke University Medical Center , Durham, NC ,
  • Michael M. Givertz
    Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School , Boston, MA ,
  • Barry M. Massie
    Section of Cardiology, San Francisco Veterans Affairs Medical Center and School of Medicine, University of California San Francisco , San Francisco, CA ,
  • Marco Metra
    Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia ,
  • John R. Teerlink
    Section of Cardiology, San Francisco Veterans Affairs Medical Center and School of Medicine, University of California San Francisco , San Francisco, CA ,
  • Adriaan A. Voors
    Department of Cardiology, University of Groningen, University Medical Centre Groningen , Groningen ,
  • Christopher M. O’Connor
    Duke Clinical Research Institute, Division of Cardiovascular Medicine, Duke University Medical Center , Durham, NC ,
  • Piotr Ponikowski
    Department of Heart Diseases, Medical University , Wroclaw ,

書誌事項

公開日
2016-05-12
権利情報
  • https://academic.oup.com/pages/standard-publication-reuse-rights
DOI
  • 10.1002/ejhf.532
公開者
Oxford University Press (OUP)

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<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Aims</jats:title> <jats:p>Episodes of acute heart failure (AHF) unfavourably affect multiple organs, which may have an adverse impact on the outcomes. We investigated the prevalence and clinical consequences of abnormal liver function tests (LFTs) in AHF patients enrolled in the PROTECT study.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and results</jats:title> <jats:p>The LFTs comprised serial assessment of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and albumin at baseline and during follow-up (daily until discharge, on days 7 and 14). The prevalence of abnormal LFTs (above upper limit of normal for AST and ALT or below lower limit of normal for albumin) was: at baseline AST 20%, ALT 12%, albumin 40%; and at day 14: AST 15%, ALT 9%, albumin 26%. Abnormal LFTs at baseline were associated with a higher risk of in-hospital death with odds ratios [95% confidence interval (CI)] of 3.5 (1.7–7.3) for AST, 3.9 (1.8–8.4) for ALT, and 2.8 (1.3–5.9) for albumin (all P &lt; 0.01). Abnormal baseline and discharge LFTs had an unfavourable impact on 180-day mortality with hazard ratios (95% CI) for baseline AST, ALT, and albumin of 1.3 (1.0–1.7), 1.1 (1.0–1.2), 1.4 (1.1–1.8), respectively, and 1.5 (1.1–2.0), 1.5 (1.0–2.2), and 1.6 (1.2–2.1), for discharge AST, ALT, albumin, respectively (all P &lt; 0.05). Analysis of LFTs trajectories (calculated as changes in LFTs over time) revealed that increasing AST and ALT on day 3 as well as decreasing albumin on day 4 were independent prognosticators of 180-day outcome (all P &lt; 0.05).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Abnormal LFTs are frequent in AHF at baseline and during hospital stay and predict worse outcomes. Whether this association is causal and what are the underlying mechanisms involved require further study.</jats:p> </jats:sec>

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