Department of Cardiology, China-Japan Friendship Hospital , Beijing , China.
State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science , Beijing , China.
Biomarkers. 2019 Nov;24(7):631-637. doi: 10.1080/1354750X.2019.1652686. Epub 2019 Aug 29.
The prognostic utility of serum albumin level for mortality in heart failure patients has received considerable attention. This meta-analysis sought to examine the prognostic significance of hypoalbuminemia for prediction of all-cause mortality in patients with heart failure. Pubmed and Embase databases were systematically searched up to 10 March 2019 to identify eligible studies. Epidemiological studies reporting a multivariable-adjusted risk estimate of all-cause mortality associated with hypoalbuminemia in acute or chronic heart failure patients were included. Nine studies from 10 articles involving 16,763 heart failure patients were included in the final analysis. Hypoalbuminemia was associated with an increased in-hospital mortality (risk ratio [RR] 4.90; 95% confidence interval [CI] 2.96-8.10) and long-term all-cause mortality (RR 1.75; 95% CI 1.35-2.27) in acute heart failure patients. Chronic heart failure patients with hypoalbuminemia exhibited a 3.5-fold (95% CI 1.29-9.73) higher risk for long-term all-cause mortality. Hypoalbuminemia is possibly an independent predictor of all-cause mortality in patients with acute or chronic heart failure. However, the current findings should be further confirmed in future prospective studies. Moreover, future well-designed randomized controlled trials would be required to investigate whether correcting hypoalbuminemia in heart failure patients has potential to improve survival outcome.
血清白蛋白水平对心力衰竭患者死亡率的预后作用受到了广泛关注。本荟萃分析旨在探讨低白蛋白血症对心力衰竭患者全因死亡率预测的预后意义。系统检索了 PubMed 和 Embase 数据库，截至 2019 年 3 月 10 日，以确定符合条件的研究。纳入了报告低白蛋白血症与急性或慢性心力衰竭患者全因死亡率的多变量校正风险估计相关的流行病学研究。最终分析纳入了 10 篇文章中的 9 项研究，涉及 16763 例心力衰竭患者。低白蛋白血症与急性心力衰竭患者的住院内死亡率（风险比 [RR] 4.90；95%置信区间 [CI] 2.96-8.10）和长期全因死亡率（RR 1.75；95% CI 1.35-2.27）增加相关。低白蛋白血症的慢性心力衰竭患者长期全因死亡率的风险增加 3.5 倍（95% CI 1.29-9.73）。低白蛋白血症可能是急性或慢性心力衰竭患者全因死亡率的独立预测因子。然而，未来的前瞻性研究需要进一步证实这些发现。此外，需要未来精心设计的随机对照试验来研究纠正心力衰竭患者的低白蛋白血症是否有可能改善生存结局。
