Abstract 17453: The Relationship Between Hemoconcentration and Congestive Hepatopathy on Clinical Outcomes in Patients With Acute Decompensated Heart Failure
Background: Hemoconcentration (HCT) and congestive hepatopathy (CH) were known to be related with mortality and morbidity in patients (pts) with acute decompensated heart failure (ADHF). However, the relationship between HCT and CH in the prediction of clinical outcomes in ADHF remains unknown.
Methods and Results: We analyzed 215 ADHF pts (123 males, 63±14 years old, 63 ischemic origin, left ventricular ejection fraction 33.0±15.1%). We defined HCT as at least two top tertiles of hematocrit, protein and albumin change between admission and one month after discharge. We also defined CH as elevated total bilirubin level between admission and one month after discharge. Cardiovascular (CV) event was a composite clinical endpoint of all-cause mortality and HF rehospitalization. During follow-up period (median 696, IQR 179-1242 days), CV events occurred in 105 ADHF pts (48.8%) including 37 (17.2%) all-cause mortality. HCT was observed in 35.3% (n=76) and CH was 32.1% (n=69). In univariate Cox regression analysis, HCT (HR 0.612, 95% CI 0.397-0.943, p=0.026) and CH (HR 1.613, 95% CI 1.084-2.401, p=0.018) were prognostic markers for predicting CV events. The Kaplan-Meier analysis showed that HCT with no-CH group had significantly lower CV events compared with other groups (36.4% vs 56.0% vs 48.4% vs 66.7%, log-rank p=0.011). In Cox proportional hazard analysis, HCT with no-CH was an independent predictor of lower CV events after adjusting other HF confounding factors (HR 0.494, 95% CI 0.263-0.929, p=0.029).
Conclusion: Our study demonstrated that HCT with no-CH had an independent and additive power for predicting better clinical outcomes in ADHF patients. Therefore, simple, inexpensive measurements of HCT and CH between admission and one month after discharge will help in the risk stratification of pts with ADHF.
- © 2013 by American Heart Association, Inc.