Abstract 12733: Urinary Albumin to Serum Albumin Ratio is a Novel Indicator for Poor Prognosis in Patients with Chronic Heart Failure
Renal insufficiency and albuminuria are established risk factors of chronic heart failure (CHF). It was also reported that low serum albumin (sAlb) level as an indicator of malnutrition is associated with unfavorable prognosis in patients with CHF. Therefore, we hypothesized that high urinary albumin (uAlb) to sAlb ratio is associated with poor prognosis in patients with CHF.
We measured sAlb and uAlb levels in consecutive 253 patients. The uAlb/creatinine ratio (UACR) was used to detect increased albumin excretion.
There were 71 cardiac events including 10 deaths and 61 rehospitalizations for worsening CHF during 928 days of median follow-up period.
UACR was increased with advancing New York Heart Association (NYHA) functional class, which inversely correlated with sAlb levels (r=-0.334, P≤0.001). UACR was also increased with advancing malnutrition status. Further, UACR/sAlb ratio was increased with advancing NYHA functional class. The Cox hazard analysis showed that UACR/sAlb ratio was an independent predictor of cardiac events after adjusting age, gender, NYHA functional class, and serum brain natriuretic peptide level (hazard ratio 1.32, 95% CI 1.15-1.63). The optimal value of UACR/sAlb ratio for predicting cardiac events was determined as those with the largest sum of sensitivity plus specificity on receiver operating characteristics (cut-off=15). Kaplan-Meier analysis revealed that patients with high UACR/sAlb ratio had significantly higher cardiac event rates compared to those with low one (log-rank test p≤0.001).
In conclusion, high UACR/sAlb ratio is a feasible prognostic indicator in patients with CHF.
- © 2013 by American Heart Association, Inc.